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From the left to the right: 13-year experience in laparoscopic living donor liver transplantation

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Abstract

Living Donors are the best theoretical candidates to benefit from the advantages of laparoscopy, but development was slow because of concerns about graft integrity and donor safety. Herein our 13-year experience in laparoscopic Living Donor Liver Transplantation (LDLT) is presented. Laparoscopic Left Lateral Section (LLLS) was performed in children receiver, while Laparoscopic Left Hepatectomy (LLH)—including or not the middle hepatic vein—and Laparoscopic Right Hepatectomy (LRH) in adults. Two senior surgeons were always involved for each procedure. All donors were first-degree relatives. From 2001 to 2014, 71 procedures were performed: 63 LLLS (88.7 %, 6 LLH (8.4 %), and 2 LRH (2.8 %). Surgical procedures required a mean of 271.1 ± 65.9, 318 ± 40.2, and 480 ± 0 min for LLLS, LLH, and LRH, respectively with a learning curve toward LLLH over the years (r = 0.09). Seven procedures (9.8 %) required conversion. The mean hospital stay was 5.5 ± 3.4, 5.3 ± 0.6, and 8 ± 0 days for LLLS, LLH, and LRH, respectively. Complications occurred in 11 patients (17.3 %) undergoing LLLS: 8 (12.7 %) grade I and 3 (4.7 %) grade II, according to the Modified Clavien–Dindo classification. Laparoscopic liver resection for LDLT requires an equivalent and parallel expertise in open LDLT and LLR. If LLLS for LDLT is now in an exploration phase in highly specialized centers, LLH and LRH for LDLT in adults lack evidence and cannot be recommended for wide introduction. For laparoscopic LDLT beginners, LLLS offers optimal conditions.

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Abbreviations

LT:

Liver transplantation

LDLT:

Living donor liver transplantation

LLR:

Laparoscopic liver resection

LLLS:

Laparoscopic left lateral section

LRH:

Laparoscopic right hepatectomy

LLH:

Laparoscopic left hepatectomy

POD:

Post operative day

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Conflict of interest

The authors declare no conflict of interest.

Ethical Standard

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Research involving human participants and/or animals

This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Authors and Affiliations

  1. Department of Hepatobiliary Surgery and Liver Transplantation, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, 47-83 Boulevard de l’Hôpital, 75013, Paris, France

    Raffaele Brustia, Shohei Komatsu, Claire Goumard, Denis Bernard & Olivier Scatton

  2. Department of Hepatobiliary Surgery and Liver Transplantation, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris, 100 Boulevard du Général Leclerc, 92110, Clichy, France

    Olivier Soubrane

  3. Université Pierre et Marie Curie, Paris, France

    Raffaele Brustia, Claire Goumard & Olivier Scatton

  4. Université Diderot, Paris, France

    Olivier Soubrane

Authors
  1. Raffaele Brustia
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  2. Shohei Komatsu
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  3. Claire Goumard
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  4. Denis Bernard
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  5. Olivier Soubrane
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  6. Olivier Scatton
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Corresponding author

Correspondence to Olivier Scatton.

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Brustia, R., Komatsu, S., Goumard, C. et al. From the left to the right: 13-year experience in laparoscopic living donor liver transplantation. Updates Surg 67, 193–200 (2015). https://doi.org/10.1007/s13304-015-0309-0

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  • DOI: https://doi.org/10.1007/s13304-015-0309-0

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