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Liver Donor Living Donor Risks

Laparoscopic Live Liver Donation Still Has Issues

In the transplant industry’s constant bid to “increase the donor pool”*, some researchers are now pushing toward laparoscopic hemihepatectomy (aka liver lobe removal) to reduce patient scarring, reduce pain (theoretically) and recovery time (also theoretically).

But some researchers don’t think surgeons should be all gung-ho yet:
 

However, adding a completely laparoscopic approach may increase donor risk. The authors have had a Grade III biliary complication (Clavien Dindo) [5] in one of the four donors in this series, which is directly attributable to the laparoscopic approach.

In addition, there are some technical issues, inherent in the laparoscopic technique described, which may compromise the graft, when compared to a standard open technique. The warm ischemia time (up to 6.5?min in the series) is higher than in open procurement. The stapled transection of the outflow of the graft may prolong the venting of the graft and may lead to loss of length of the outflow. There may be shortening of portal vein as well due to stapling during laparoscopy.

 
If you are a prospective liver donor, MAKE SURE to discuss these issues with your surgeon prior to making your final decision.
 
 
Full letter: http://onlinelibrary.wiley.com/doi/10.1111/ajt.12612/full
 
*Put that phrase into a search engine and see what appears. You’ll get the point.

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