Complications of laparoscopic and open donor hepatectomy for living donor liver transplantation: single center experience

Abstract

Objectives: Donor hepatectomy is a major surgery with a relatively safe profile and a reported complication rate of ~20%. Most complications are non-life threatening and are resolved with conservative measures. However, rare complications may need invasive precautions, ranging from percutaneous interventions to surgeries. Materials and Methods: We retrospectively analyzed all living donor hepatectomies at our center. Donors were divided into 2 groups: laparoscopic and open procedures. We collected preoperative, intraoperative and postoperative data of donors. Donor complications were recorded separately intraoperatively and postoperatively according to the Clavien-Dindo postoperative complication classification system. Results: Between July 2018 and April 2023, 215 living donors had hepatectomies, including 48 laparoscopic and 167 open donor hepatectomies. Among donors, 91 were female donors (42.3%) and 124 were male donors (57.7%). The mean age of all donors was 33.5 ± 8.1 years, and the mean body mass index (in kilogram divided by meters squared) was 24.6 ± 3.8. Among donors, 124 underwent right and 91 underwent left or left lateral hepatectomies. The mean operative time for all donors was 301 ± 83 minutes, the mean hospital stay was 5.8 ± 1.4 days, and the mean follow-up was 31.9 ± 15.8 months. Four patients (1.8%) had intraoperative complications, including 2 cases of bleeding, 1 diaphragm perforation, and 1 portal vein stenosis. Fourteen patients (7.4%) had major postoperative complications, with 5 patients requiring surgical intervention. Conclusions: Donor hepatectomy is a complicated surgery that requires extensive preoperative preparation and appropriate donor selection. Postoperative donor complications can be diagnosed early with close follow-up, and a multidisciplinary approach is essential for complication management. © Başkent University 2024 Printed in Turkey. All Rights Reserved.