Related Experiment Video
Updated: Jul 13, 2026
07:17
Single Port Donor Nephrectomy
Published on: March 12, 2011
51.2K
Midline Incision Living Donor Liver Transplantation as a Step Toward Minimally Invasive Liver Transplantation: A
A Rammohan1, K Palaniappan1, Y Puri1
1The Institute of Liver Disease & Transplantation, Dr. Rela Institute & Medical Centre, Bharath Institute of Higher Education & Research, Chennai, India.
World Journal of Surgery
|April 22, 2025
Summary
Midline incision liver transplant (MILT) is a feasible and safe approach for living donor liver transplant recipients. While it showed increased blood transfusion needs, MILT did not significantly impact major morbidity or long-term mortality compared to standard incisions.
Area of Science:
- Hepatobiliary Surgery
- Transplant Surgery
- Minimally Invasive Surgery
Background:
- Living donor liver transplant (LDLT) recipient surgery can be performed via midline incision (MILT).
- MILT may reduce perioperative morbidity and wound complications.
- MILT is considered a foundational skill for minimally invasive recipient surgery (MIRS).
Purpose of the Study:
- To evaluate the feasibility and safety of MILT in LDLT recipients.
- To compare perioperative outcomes of MILT versus standard liver transplant incisions (SILT).
- To highlight technical modifications and evolution of the MILT procedure.
Main Methods:
- Propensity score matched analysis of 75 MILT and 150 SILT patients.
- Comparison of operative time, ischemia times, blood loss, and transfusion requirements.
- Assessment of 90-day major morbidity, hospital stay, and long-term mortality.
Main Results:
- No significant differences in operative time or cold ischemia time between MILT and SILT.
- Significantly longer warm ischemia time in the MILT group (p=0.02).
- Higher blood transfusion requirements (packed red cells and fresh frozen plasma) in MILT patients (p=0.03 and p=0.02, respectively).
- No significant difference in 90-day major morbidity, hospital stay, or 1- and 3-year mortality.
Conclusions:
- MILT is a feasible and safe surgical approach for LDLT recipients.
- Proficiency in MILT is valuable for surgeons pursuing MIRS.
- MILT offers potential benefits in reducing wound-related issues and morbidity.
