Laparoscopic living donor hepatectomy for pediatric liver transplantation in chile

Abstract

Living donor liver transplantation is a safe and widely accepted procedure for pediatric transplantation. This technique is associated with a low rate of complications and almost no mortality and good results for recipients. Left lateral segmentectomy is the most used technique. We have performed 254 pediatric liver transplants, 60 of them with living donors utilizing open technique. We started in 2015 a program of laparoscopic liver donor hepatectomies (LLDH). The aim of this article is to present these results. All LLDH performed between 2015 and December 2017 are included. Technique: 4 trocars of 11/12 mm. were inserted; 2 in right and left hypochondrio, 1 in midline 2-3 cm. above umbilicus and 1 in epigastric for liver retraction. Haemolock was use for vascular control. Parenchymal transection was done with Herbejet and Harmonic. The liver was extracted through a transverse suprapubic incision. Results: We performed 14 LLDH during this period. Eleven men and three women. Median age was 30.5 years. Median operative time was 5 hours. In one case we used the hand assisted technique. One patient presented with a biliary leak, treated with endoscopic prosthesis. No other complications were presented. Median length of stay was 3.5 days. Recipients were between 11 months and 10 years old. No surgical complications were reported. One presented acute cellular rejection. No mortality is reported in this series. Conclusions: Laparoscopic living donor hepatectomy is a safe technique for donors and recipients. Teams with great experience are needed to perform this procedure in a safe way.