Pure Laparoscopic Versus Open Right Hepatectomy in Living Liver Donors: Graft Weight Discrepancy

Abstract

Background Accurate volumetric evaluation of donors’ livers before surgery is crucial for successful living-donor liver transplantation. However, there are few studies on the volumetric evaluation in the recently popularized pure laparoscopic donor hepatectomy method, in contrast to the number of studies for conventional donor hepatectomy. We aimed to analyze the difference between estimated graft weight and actual graft weight in pure laparoscopic donor right hepatectomy (PLDRH) and conventional donor right hepatectomy (CDRH) procedures. Material/Methods The medical records of 612 donors who underwent right hepatectomy in living-donor liver transplantation between January 2014 and December 2020 were retrospectively reviewed. The CDRH group targeted patients from January 2014 to October 2015, and the PLDRH group targeted patients from March 2016 to December 2020. Results There were 119 and 376 donors who underwent CDRH and PLDRH, respectively. Although there was no significant difference in the estimated graft weights ( P =0.994) and actual graft weights ( P =0.489) between the groups, the estimated graft weights were significantly higher than the actual graft weights in both groups. However, the estimated graft weight and actual graft weight showed linear correlations in both the CDRH (r=0.81, P <0.001) and PLDRH (r=0.76, P <0.001) groups, with the CDRH group having greater linearity. Conclusions The estimates of graft weight were similar between the 2 groups. However, since the actual graft weight tended to be smaller in the PLDRH group, this should be considered before surgery.

Criteria for selecting living liver donors to optimize recipient outcomes in pure laparoscopic donor right hepatectomy: a cohort study

“…Nevertheless, notably, the estimated remnant liver volume is an approximation, and discrepancies between the estimated remnant liver volume and actual graft weight can occur. Additionally, our previous findings indicated that the actual graft weight tended to be smaller in cases of PLDRH compared with CDRH 37 . This highlights the need for heightened caution during PLDRH procedures.…”

Insights from Seoul National University Hospital’s experience: a systematic review of pure laparoscopic donor hepatectomy progression

“…Additionally, the estimated graft weight did not differ significantly between PLDRH and open donor right hepatectomy. However, given that the actual graft weight tended to be lower in the PLDRH group, this should be taken into consideration during pre-surgical planning ( 46 ). In summary, the attainment of safety and feasibility in PLDRH procedures requires not just the proficiency of the donor surgeon, but also the competence and experience of the entire surgical team in both bench surgery and recipient surgery.…”

Phẫu thuật nội soi lấy mảnh ghép gan phải trong ghép gan từ người hiến sống: Báo cáo 27 trường hợp đầu tiên tại Việt Nam

“…Phương pháp này yêu cầu cao hơn về mặt kỹ thuật nhằm đảm bảo sự an toàn người hiến cũng như chất lượng mảnh gan ghép. Hiện nay, một số nghiên cứu đa trung tâm với cỡ mẫu lớn bước đầu cho thấy tính khả thi và an toàn của phẫu thuật nội soi lấy mảnh gan ghép [2][3][4][5].…”

“…GRWR 1,1 ± 0,2%, đảm bảo thể tích an toàn theo khuyến cáo. Kết quả này tương đồng với nhiều nghiên cứu 1,0-1,3% [4,5,7]. Trong nghiên cứu của Hong trên mảnh ghép có khối lượng trên 1000g, tỉ lệ GRWR trung bình là 1,7% [2].…”