Living donor liver resection: a low-tech but highly efficient technique. The Regensburg experience

Abstract

Background: To evaluate a low-tech blunt liver dissecting technique for living-liver-donor procedures. Thirty three adult-to-adult living-donor operations were performed at Regensburg University and Jordan Hospital, Amman.

Patients and methods: For the technique of parenchymal dissection, dissecting scissors were used for blunt preparation; branches were closed, carefully pressing into the hepatic parenchyma. Donor, surgical procedure data, and data on liver function and recovery were analyzed and compared to literature.

Results: Median procedure time was 280 min (210 to 420 min). Median blood loss was 350 ml (0 to 650 ml). GOT levels decreased from 260 U/l (140 to 510 U/l) on day 1 to 65 U/l (31 to 220 U/l) on day 7. Bilirubin levels were at 2.0 mmol/l (1.29 to 5.99 mmol/l) on day 1 and 1.26 mmol/l (0.63 to 4.70 mmol/l) on day 7. After 12 days (6 to 23), all donors were discharged. There was no donor mortality. One major complication (biliary leakage) and seven minor complications occurred.

Conclusion: This technique is a low-tech but efficient donor-dissection technique in living liver transplantation, which is comparable to other well established dissection techniques utilizing technical devices in regards to risk for the donor, performance, and recovery.