Largest US Series of Minimally Invasive Full and Laparoscopy-Assisted Living Donor Hepatectomy.
Surgery, New York Presbyterian/Columbia University, New York, NY
Meeting: 2017 American Transplant Congress
Abstract number: 368
Keywords: Donation, Laparoscopy, Liver transplantation, Outcome
Session Information
Session Name: Concurrent Session: Liver Living Donors and Partial Grafts
Session Type: Concurrent Session
Date: Monday, May 1, 2017
Session Time: 4:30pm-6:00pm
Presentation Time: 4:54pm-5:06pm
Location: E451a
Columbia University Medical Center (CUMC) has offered minimally invasive donor hepatectomies since 2008. Donor hepatectomies have been performed using 3 access routes (1) hybrid technique; (2)fully laparoscopic; (3) open with a midline incision and right subcostal extension. The aim of this study is to review and compare the surgical outcomes of donors at CUMC by surgical technique.
Methods: Donors at CUMC were prospectively enrolled in a database. Operations performed between 2008 and 2016 were included based on access to electronic medical records. Data including demographics, intraoperative information, and postoperative complications were compared.
Results: There were no significant differences in donor demographics (see Table 1). Patients had an average length of follow-up of 2.3 years at the time of data analysis.
| Full | Hybrid | Open | |
| Technique (n) | 33 | 97 | 29 |
| Age (y) | 37 (21-53) | 39 (20-63) | 39 (20-63) |
| BMI (kg/m2) | 24.1 (19.1-31.5) | 25.6 (16.2-41.5) | 25.5 (19.6-37.7) |
| Sex, male (%) | 52 | 47 | 48 |
| Graft Type (n) | |||
| Right | 2 | 53 | 12 |
| Left | 7 | 44 | 12 |
| LLS | 24 | 0 | 5 |
| Prior Abdominal Surgery (n) | 8 | 24 | 11 |
| History of Hernia (n) | 8 | 8 | 1 |
There was significantly less blood loss and length of hospitalization for full laparoscopy (4.4 vs 6.1 and 6.4 days). Overall complication rates were equivalent for all three groups (p=.15). There were fewer complications during the follow-up period for full laparoscopic compared to hybrid and open (13%, 41%, and 29%, respectively; p=.03). The most common complications are listed below.
| Complication (% patients) | Full | Hybrid | Open | p |
| Blood Transfusion | 0 | 0 | 3 | <.01 |
| Bile Leak | 3 | 11 | 7 | <.01 |
| Biloma | 0 | 5 | 0 | .19 |
| Hernia | 0 | 15 | 17 | .05 |
| Wound Complication | 6 | 13 | 13 | .50 |
| Pain/Nausea/Emesis | 15 | 14 | 31 | .11 |
| Neuropraxia | 6 | 2 | 14 | .80 |
| Ileus | 6 | 8 | 17 | .26 |
Conclusions: Minimally invasive techniques are associated with decreased morbidity, blood loss, and length of hospitalization for donors. Experience at CUMC suggests non-inferiority has been reached for minimally invasive techniques.
CITATION INFORMATION: Collins K, Emond J, Fox A, Samstein B. Largest US Series of Minimally Invasive Full and Laparoscopy-Assisted Living Donor Hepatectomy. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Collins K, Emond J, Fox A, Samstein B. Largest US Series of Minimally Invasive Full and Laparoscopy-Assisted Living Donor Hepatectomy. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/largest-us-series-of-minimally-invasive-full-and-laparoscopy-assisted-living-donor-hepatectomy/. Accessed November 22, 2024.« Back to 2017 American Transplant Congress