Donor safety for minimal invasive hepatectomy in liver transplantation: the Korean Organ Transplantation Registry

Abstract

Background: The most important concern in living donor liver transplantation (LDLT) is donor safety. Although minimally invasive living donor surgery has been increasingly accepted, its safety remains to be fully clarified in a large-scale study. This study evaluated the safety and effectiveness of minimal invasive living donor hepatectomy in comparison with conventional open procedure using Korean Organ Transplantation Registry data. Methods: We reviewed the prospectively collected data of all 1694 living liver donors who underwent procedures between April 2014 and December 2017. We allocated the donors to a minimal invasive group (MIG, n = 304) and a open group (OG, n = 1390) and analyzed the relations clinical data and complications. Results: The median follow-up was 31 months. During the study period, 1071 men and 623 women donated livers and there were no deaths after living liver donation. The overall complication rates were 7.3% and 4.5% in the two group. (p = 0.43) In the MIG, the AST level at I year after donation was lower than OG (20.4 ± 5.5 mg/dL versus 22.4 ± 9.1 mg/dL, p = 0.003) On the hand, the total bilirubin level at 6 months after donation was higher (0.84 ± 0.39 mg/dL versus 0.74 ±0.36 mg/dL, P < 0.001)The MIG was shorter than OG in duration of hospitalization. (9.04 ± 3.78 days versus 10.29 ± 4.01 days, p < 0.001) Conclusions: The minimal invasive donor hepatectomy was relatively some higher complication rate which was no statistically significant difference but lower duration of hospitalization in compare to conventional open procedure in our study.