Water-Jet Dissection for Donor Hepatectomy during Living Donor Liver Transplantation
1Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
2Health Science, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
Meeting: 2018 American Transplant Congress
Abstract number: D236
Keywords: Liver transplantation, Living-related liver donors, Safety, Surgical complications
Session Information
Date: Tuesday, June 5, 2018
Session Name: Poster Session D: Liver: Living Donors and Partial Grafts
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Background The most important issue in living donor liver transplantation (LDLT) is donor safety. Although donor hepatectomy has evolved technically over the years, it is inevitable to encounter donor mortality and morbidity at a certain incidence. From April 2016, we began to perform water-jet dissection for donor hepatectomy in LDLT to reduce postoperative complications of living donor.
Aim To evaluate the feasibility, safety and efficacy of water-jet dissection for living donor hepatectomy
Patients and methods 258 LDLT was performed at our institute between 1998 and 2017. A total of 12 consecutive living liver donors underwent parenchymal dissection with water-jet dissector (ERBEJET 2), including two cases of in situ S2 monosegmentectomy, left lateral segmentectomy (n = 4), left hepatic lobectomy with or without the caudate lobe (n = 5), and right hepatic lobectomy (n = 1) (WJ group). We compared the clinical data between the WJ group and the group of donors in whom traditional open donor hepatectomy was performed with the ultrasonic aspirator (CUSA) from 2013 to 2016 (CUSA group, n = 43).
Results 1) Demographic characteristics of the donors were similar between WJ group and CUSA group. 2) The hepatic transection time was similar between WJ (117 ± 37 min) and CUSA (119 ± 42 min) groups (P=0.89). 3) The volume of blood loss was 445 ± 189 ml in WJ group and 344 ± 223ml in ODH group (P=0.16). No allogeneic blood transfusion was performed in both groups. 4) There was no perioperative or postoperative mortality in both donor groups. Postoperative morbidity (Clavien grade ≥ 3) was not observed in WJ group. On the other hand, it was observed in 5 donors (11.6 %) with bile leakage (n=2), hemorrhage (n=2), and delayed gastric emptying (n=1) in CUSA group.
Conclusions Water-jet dissection for donorhepatectomy during LDLT was quite safe and effective.
CITATION INFORMATION: Gotoh K., Eguchi H., Iwagami Y., Yamada D., Asaoka T., Noda T., Kawamoto K., Kobayashi S., Umeshita K., Doki Y., Mori M. Water-Jet Dissection for Donor Hepatectomy during Living Donor Liver Transplantation Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Gotoh K, Eguchi H, Iwagami Y, Yamada D, Asaoka T, Noda T, Kawamoto K, Kobayashi S, Umeshita K, Doki Y, Mori M. Water-Jet Dissection for Donor Hepatectomy during Living Donor Liver Transplantation [abstract]. https://atcmeetingabstracts.com/abstract/water-jet-dissection-for-donor-hepatectomy-during-living-donor-liver-transplantation/. Accessed November 20, 2019.« Back to 2018 American Transplant Congress