Living donor liver transplantation has become a standard of care in many regions of the world. Live liver donation is associated with a high incidence of donor morbidity limiting the application. We report the first North American series of fully laparoscopically procured left lobe and left lateral segments grafts for live donor liver transplantation. We performed 13 laparoscopic cases with 1 conversion.

Methods:

We reviewed donor and recipient demographics. We analyzed donor outcomes with regard to peak Total bilirubin, INR, AST, hospital stay, and complications and compared them to previous 20 LLS cases performed with standard open technique. We analyzed recipient graft and patient survival.

Results:

Eighty-five percent of the lap donors were male. The average age of donors was 35.1. The average BMI was 27.4. Sixty percent of the laparoscopic LLS were obese with BMI > 28. The majority of donors were Caucasian. The mean operative time in was 414 minutes. The mean LOS in the laparoscopic group was statistically significantly shorter than the open group, 3.9 days to 6.2 days respectively.

We performed two full left lobe into 13 yo with AIH weighing 43.6 kg and 52 yo cryptogenic cirrhosis weighing 59.5kg. Graft weights were 407 and 396grams with GRWR of 0.93 and 0.66 respectively. EBL in full left lobes cases was 100 and 125mL.

All laparoscopically procured grafts had immediate function and 1 year graft and patient survival is 92% and 100%.

Conclusions: Laparoscopic LLS procurement can be expanded to full left lobes with the potential to significantly decrease living donor liver morbidity.

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