• Olivier Soubrane, Susumu Eguchi, Shinji Uemoto, KwonChoon Hyuck DavidCHDDepartment of General Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, OH., Go Wakabayashi, Ho-Seong Han, Ki-Hun Kim, Roberto Ivan Troisi, Daniel Cherqui, Fernando Rotellar, François Cauchy, Akihiko Soyama, Satoshi Ogiso, Gyu-Seong Choi, Takeshi Takahara, Jai Young Cho, Hwui-Dong Cho, Aude Vanlander, Gabriella Pittau, Olivier Scatton, Fernando Pardo, and Talia Baker.
• Department of HPB Surgery and Liver Transplant, Beaujon Hospital, Assistance Publique - Hôpitaux de Paris and University of Paris, France.
• Ann. Surg. 2022 Jan 1; 275 (1): 166-174.

ObjectiveEvaluating the perioperative outcomes of minimally invasive (MIV) donor hepatectomy for adult live donor liver transplants in a large multi-institutional series from both Eastern and Western centers.BackgroundLaparoscopic liver resection has become standard practice for minor resections in selected patients in whom it provides reduced postoperative morbidity and faster rehabilitation. Laparoscopic approaches in living donor hepatectomy for transplantation, however, remain controversial because of safety concerns. Following the recommendation of the Jury of the Morioka consensus conference to address this, a retrospective study was designed to assess the early postoperative outcomes after laparoscopic donor hepatectomy. The collective experience of 10 mature transplant teams from Eastern and Western countries was reviewed.MethodsAll centers provided data from prospectively maintained databases. Only left and right hepatectomies performed using a MIV technique were included in this study. Primary outcome was the occurrence of complications using the Clavien-Dindo graded classification and the Comprehensive Complication Index during the first 3 months. Logistic regression analysis was used to identify risk factors for complications.ResultsIn all, 412 MIV donor hepatectomies were recorded including 164 left and 248 right hepatectomies. Surgical technique was either pure laparoscopy in 175 cases or hybrid approach in 237. Conversion into standard laparotomy was necessary in 17 donors (4.1%). None of the donors died. Also, 108 experienced 121 complications including 9.4% of severe (Clavien-Dindo 3-4) complications. Median Comprehensive Complication Index was 5.2.ConclusionsThis study shows favorable early postoperative outcomes in more than 400 MIV donor hepatectomy from 10 experienced centers. These results are comparable to those of benchmarking series of open standard donor hepatectomy.Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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