Pediatric living donor liver transplantation: results of laparoscopic vs. open graft removal.

Autores de IIS La Fe

• David Crehuet Gramatyka

  Autor

• Anna Betlem Domenech Tarrega

  Autor

• Carsten Driller

  Autor

• Lucia Mangas Alvarez

  Autor

• Javier Maupoey Ibáñez

  Autor

• Irene Dieguez Hernandez-Vaquero

  Autor

• Francisco Jesús Negrín Rodríguez

  Autor

• María Ángeles Martinez Gómez

  Autor

• Juan José Vila Carbó

  Autor

Participantes ajenos a IIS La Fe

• Vigúria Marco I

Grupos

• Hepatología experimental y Trasplante hepático

  Investigador Principal

  Laia Tolosa Pardo

• Hepatología, Cirugia Hepatobiliopancreática y Trasplantes

  

  Leader

  Marina Berenguer Haym

Abstract

INTRODUCTION: Laparoscopic graft removal for pediatric living donor liver transplantation (PLDLT) reduces morbidity and surgical aggressiveness for the donor. It is important to assess whether the approach used for removal purposes compromises implantation. The objective of this study was to analyze PLDLT progression in children according to whether the graft had been removed laparoscopically or through open surgery. MATERIAL AND METHODS: A retrospective, analytical cohort study of PLDLTs carried out in our institution from 2009 to 2020 was carried out. RESULTS: Transplantation was performed in 14 patients, with a median age of 34.5 (R: 6-187) months. In 6 donors (42%), graft removal was conducted laparoscopically. In 1 donor (7%), removal was initiated laparoscopically, but conversion was required. This patient was included within the open surgery group, which consisted of 8 (58%) donors. No differences were found in terms of operating times, ICU stay, hospital stay, complications during admission, or complications post-admission in the recipient. The surgical approach did not compromise the length of the vessels to be anastomosed in any graft, and it added no extra difficulty to implantation. No differences were found in terms of removal times or hospital stay for the donor. Only 1 donor from the laparoscopy group required re-intervention due to bleeding following port insertion. CONCLUSION: PLDLT patients had similar results regardless of the removal approach used, which did not compromise the structures of the graft to be anastomosed, or add any extra difficulty to implantation.

Keywords

• Laparoscopy; Liver graft removal; Living donor; Pediatric liver transplantation