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The Current State of Minimally Invasive Living Donor Hepatectomy

  • Liver Transplantation (D Mulligan and R Batra, Section Editors)
  • Published:
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Abstract

Purpose of Review

To evaluate the current state of minimally-invasive living donor hepatectomy by briefly summarizing its history, examining up-to-date technical considerations, reviewing important recently published reports, and discussing the path forward to continued progress.

Recent Findings

The last several years have seen a surge in reports of purely laparoscopic major donor hepatectomy. These accounts span several continents and include updates from centers with significant experience. Other studies come as case reports or small case series from centers just developing their minimally invasive expertise. There are now centers that perform purely laparoscopic donor hepatectomies with no donor selection criteria with equivalent outcomes compared with conventional hepatectomy. However, even these centers continue to urge caution in donors with complex variant anatomy.

Summary

Rapid growth in minimally invasive donor hepatectomy has developed within the past decade. There is no single technique adopted by all centers, and regional and center-specific preferences continue to exist. Equivalent outcomes can be achieved with appropriate donor selection that matches center expertise. Despite continued progress, pure laparoscopic living donor hepatectomy should remain available only in highly specialized centers. Aggressive efforts should be made to transfer knowledge, skills, and expertise to centers transitioning to more minimally invasive approaches.

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Abbreviations

(DH):

Donor hepatectomy

(FLR):

Functional liver remnant

(GRWR):

Graft-to-recipient-weight-ratio

(LLS):

Left lateral segment

(LDLT):

Living donor liver transplant

(MHV):

Middle hepatic vein

(PLRDH):

Pure laparoscopic right lobe donor hepatectomy

(SFSS):

Small-for-size syndrome

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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  1. Department of Surgery, Division of Hepatobiliary Surgery and Liver Transplantation, New York – Presbyterian Hospital, Weill-Cornell Medical Center, New York, NY, USA

    Dustin Carpenter, Sulemon Chaudhry & Benjamin Samstein

  2. Department of Surgery, Division of Transplantation, New York – Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA

    Dustin Carpenter, Sulemon Chaudhry & Benjamin Samstein

  3. Weill Cornell Medicine, 525 East 68th Street, Payson 707, New York, NY, 10065, USA

    Benjamin Samstein

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Carpenter, D., Chaudhry, S. & Samstein, B. The Current State of Minimally Invasive Living Donor Hepatectomy. Curr Transpl Rep 7, 169–179 (2020). https://doi.org/10.1007/s40472-020-00287-x

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