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Influence of Large Grafts Weighing ≥ 1000 g on Outcome of Pure Laparoscopic Donor Right Hepatectomy

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background

Depending on a transplant center’s level of experience, utilization of pure laparoscopic donor right hepatectomy (PLDRH) may be limited due to graft size or anatomical variations. Here, we aimed to evaluate the influence of large hepatic grafts (≥ 1000 g) when performing PLDRH in both donors and recipients of such grafts.

Methods

Medical records of living donors who underwent either PLDRH from November 2015 to August 2019 or open conventional donor right hepatectomy (CDRH) from January 2010 to August 2019 and those of the graft recipients were retrospectively reviewed. Donors were separated into three groups: PLDRH graft ≥ 1000 g (n = 10; study group), PLDRH graft < 1000 g (n = 280; control-I group), and CDRH graft ≥ 1000 g (n = 24; control-II group).

Results

Total operative duration (P = 0.017) and warm ischemia time (P < 0.001) were significantly longer in the study than in the control-I and control-II groups, respectively. ΔAlanine aminotransferase% was significantly lower in the study than in the control-I group (P = 0.001). There was no significant difference in minor complication incidence between the study and control-I (P = 0.068) and control-II (P = 0.618) donors. There were no major complications in the study and control-II donors, whereas six control-I donors (2.1%) experienced a major complication (P = 1.000). Length of hospitalization was significantly shorter in the study than in the control-II group (P < 0.001). There was no significant difference in early and late major complication incidence for recipients between the study and control-I and control-II groups.

Conclusions

PLDRH for grafts weighing ≥ 1000 g appears to be safe and feasible when performed by experienced surgeons in a well-equipped center.

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Abbreviations

PLDRH:

Pure laparoscopic donor right hepatectomy

BMI:

Body mass index

CDRH:

Conventional donor right hepatectomy

ALT:

Alanine aminotransferase

Hb:

Hemoglobin

AST:

Aspartate aminotransferase

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Authors and Affiliations

  1. Department of Surgery, Seoul National University College of Medicine, 101 Daehakro, Jongrogu, Seoul, 03080, Korea

    Worakitti Lapisatepun, Suk Kyun Hong, Kwangpyo Hong, Eui Soo Han, Jeong-Moo Lee, Nam-Joon Yi, Kwang-Woong Lee & Kyung-Suk Suh

  2. Division of Hepatobiliary Pancreas Surgery, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

    Worakitti Lapisatepun

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  1. Worakitti Lapisatepun
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Contributions

WL and SKH outlined the manuscript content and made the subsequent revisions and edits.

WL drafted the manuscript.

All authors edited the manuscript.

All authors agreed on the content of the manuscript.

Corresponding author

Correspondence to Suk Kyun Hong.

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This study was approved by the Institutional Review Board of Seoul National University Hospital (IRB No. 1912-107-1089).

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The authors declare that they have no conflicts of interest.

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Lapisatepun, W., Hong, S.K., Hong, K. et al. Influence of Large Grafts Weighing ≥ 1000 g on Outcome of Pure Laparoscopic Donor Right Hepatectomy. J Gastrointest Surg 25, 1980–1988 (2021). https://doi.org/10.1007/s11605-020-04837-7

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