Pure laparoscopic left lateral sectionectomy in living donors: from innovation to development in France

Ann Surg. 2015 Mar;261(3):506-12. doi: 10.1097/SLA.0000000000000642.

Abstract

Objective: In this study, we report the results obtained from 70 living donors in France.

Background: Left lateral sectionectomy for pediatric live donor liver transplantation is a well-standardized surgical procedure. Our team introduced the laparoscopic approach to live donation in 2002, and the reproducibility and safety of this method was discussed in 2006.

Methods: Between March 2001 and October 2012, a total of 70 donors underwent a liver procurement. Sixty-seven donors (95.7%) underwent a left lateral sectionectomy, and 3 underwent a left hepatectomy without middle hepatic vein procurement. All data were prospectively recorded in a database.

Results: Of the 70 donors, 66 (94%) liver grafts were procured by laparoscopy, whereas 4 (6%) patients required conversion into an open technique. Seventeen donors experienced complications, leading to an overall complication rate of 24.2%. Eleven donors (16%) had grade 1 complications, according to the Clavien system. Five donors (7.1%) presented grade 2 complications, and 1 donor (1.4%) had a grade 3 complication. No death occurred. Overall, patient and graft survival rates for pediatric recipients were 95% and 92% at 1 year, 95% and 88% at 3 years, and 95% and 84% at 5 years, respectively.

Conclusions: The laparoscopic retrieval of the left lateral section for live donor liver transplantation is safe and reproducible and has transitioned from an innovative surgery to a development phase in France.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Diffusion of Innovation
  • Female
  • France
  • Hepatectomy / methods*
  • Humans
  • Laparoscopy / methods*
  • Liver Transplantation*
  • Living Donors*
  • Male
  • Middle Aged
  • Patient Safety
  • Postoperative Complications / prevention & control
  • Prospective Studies
  • Reproducibility of Results
  • Survival Rate
  • Treatment Outcome