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Pure laparoscopic left lateral sectionectomy in living donors: from innovation to development in France
Olivier Scatton1, Georgios Katsanos, Olivier Boillot
1*Department of Hepatobiliary Surgery and Liver Transplantation, Hôpital Saint Antoine, Assistance Publique Hôpitaux de Paris, Université Pierre et Marie Curie, Paris, France †Department of Hepatobiliary Surgery and Liver Transplantation, Hôpital Edouard Herriot, Lyon, France; and ‡Department of Anaesthesiology and Reanimation, Hôpital Saint Antoine, Assistance Publique Hôpitaux de Paris, Paris, France.
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.
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