Purpose: Laparoscopy was extended to liver donation to reduce invasiveness and our center has offered selected patients fully laparoscopic procurement since 8/12. We sought to determine the impact of offering laparoscopic donation on donor interest in LDLT.

Methods: We examined a retrospective cohort of 244 potential donors and their 206 recipients who underwent evaluation between 1/10 and 3/14. We separated our patients into two groups, based on date of donor evaluation (before or after 8/12). Potential donors were informed that the application of full laparoscopy to donor hepatectomy was novel and all consented to our IRB-approved observational protocol.

Results: An insignificant decrease in the percentage of waitlist candidates with a potential donor was observed between 2010­-2012 and 2013, from 17% to 16% (P=0.75). However, total candidates on our waitlist increased by 26% leading to a 27% increase in donor evaluations per month (P=0.07). When controlling for the rise in candidate listings, only a 1.4% increase in evaluations per month was observed. We also noted an insignificant 3.7% increase in average potential donors per recipient (P=0.52). Unrelated donors (those with a non­biological relationship to the recipient, excluding spouses) increased from 18% to 29% (P=0.04) and the biggest increase was seen in 2013 (17% to 35%, P=0.002). There was an increase in unrelated donors going on to donate from 14% to 23%, but this did not reach significance (P=0.31). We also saw an increase in female recipient candidates with a donor coming forward from 37% to 48% (P=0.04).

Conclusions: Overall, there was no increase in the percentage of waitlist candidates with a potential donor and an insignificant increase in total donors. The average number of potential donors per recipient increased slightly. However, the composition of the donor and recipient pool changed with an increase in unrelated donors and an increase in female recipients with a potential donor. This may reflect the perception that laparoscopic donor hepatectomy has less morbidity and a shorter recovery time.

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