Purely laparoscopic left donor hepatectomy with middle hepatic vein and caudate lobe

Abstract

Presenter: Essa Aleassa MD | Cleveland Clinic Foundation Background: The volume of liver transplantation has been limited in North America by the low number of liver grafts available from deceased donors. Furthermore, the invasiveness of performing an open living donor hepatectomy makes it a less appealing option to the public. The introduction of minimally invasive living donor hepatectomy has helped increase the number of liver living donors. This approach is growing in North America not yet disseminated yet due to its complexity. This video aims to showcase our approach to a purely laparoscopic left donor hepatectomy that includes the caudate lobe as well as the middle hepatic vein in an effort to maximize the volume and function of the donated left liver lobe graft. Methods: A 29-year-old male underwent a purely laparoscopic left liver lobe living donor with caudate and middle hepatic artery. The patient was preoperatively assessed and noted to be a suitable donor from an anatomical and functional standpoint. The left liver lobe with preserved middle hepatic vein and caudate lobe was resected and donated to a living donor liver transplant recipient. Results: The patient tolerated the procedure without any complications. The operative time was 6 hours and 20 minutes and the estimated blood loss was 200cc. The patient tolerated the procedure well and was discharged on postoperative day 5. Conclusion: Purely laparoscopic donor hepatectomy is a highly advanced procedure that aims to decrease enhance the recovery of living donors. Furthermore, this approach is promising to increase the number of liver transplantation performed in North America.