Donation and Procurement Posters

Tuesday July 03, 2018 from 16:30 to 17:30

Room: Hall 10 - Exhibition

P.628 Total laparoscopic living donor right hepatectomy for modified extended right graft

Jai Young Cho, Korea

Seoul National University Bundang Hospital

Abstract

Total Laparoscopic Living Donor Right Hepatectomy for Modified Extended Right Graft

Jai Young Cho1, Ho-Seong Han1, YoungRok Choi1, Sungho Kim1, Kilhwan Kim1, In Gun Hyun1.

1Surgery, Seoul National University Bundang Hospital, Seongnam, Korea

Background: Right lobe living donor liver transplantation (LDLT) is the predominant form of adult-to-adult LDLT. Accordingly, cosmetic and functional demand by young donors is increasing. We developed world first total laparoscopic donor right hepatectomy (LDRH) in adult living donors.
Methods: Total LDRH was performed in young donor without vascular clamping. Modified extended right graft (right liver including all the middle hepatic vein branches) was retrieved from suprapubic transverse incision.
Findings After full mobilization of right liver, hilar dissection was done. Firstly, right portal vein was isolated under retracting common bile duct laterally. Right hepatic artery was cautiously dissected and isolated without injuring. An exact transection line was drawn during transient clamping of the hepatic artery and portal vein on the right side of the liver using bulldog clamp.
Dissection was meticulously performed along the right side of the middle hepatic vein until the origin of middle hepatic vein until exposure of the hilar plate. Anterior section vein branches (V5 and V8) were finely dissected and were reconstructed using an artificial vascular graft.  A modified extended right graft with preservation of the middle hepatic vein branches was extracted through the suprapubic incision. There was no complication in both donor and recipient. After follow-up of more than one year, donor and recipient live well with normal liver function.
Conclusion: Total LDRH was feasible in selected adult donors. If this procedure will be more standardized, total LDRH will be new option for adult LDLT, which meets demand by donors and diminish guilty feeling by recipients.

Presentations by Jai Young Cho



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