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Laparoscopic liver resection for living donation: Where do we stand?

World Journal of Gastroenterology 2014年第42期20卷 15590-15598页

作者： Fran?ois Cauchy Lilian Schwarz Olivier Scatton Olivier Soubrane Service de Chirurgie Hépato-Bilio-Pancréatique et Transplantation Hépatique H?pital Saint-Antoine Assistance Publique - H?pitaux de Paris Department of HPB Surgery and Liver Transplantation Hopital Beaujon

In Western countries, living donor liver transplantation (LDLT) may represent a valuable alternative to deceased donor liver transplantation. Yet, after an initial peak of enthusiasm, reports of high rates of complications and of fatalities have led to a certain degree of reluctance towards this procedure especially in Western countries. As for living donor kidney transplantation, the laparoscopic approach could improve patient’s tolerance in order to rehabilitate this strategy and reverse the current trend. In this setting however, initial concerns regarding patient’s safety and graft integrity, need for acquiring surgical expertise in both laparoscopic liver surgery and living donor transplantation and lack of evidence supporting the benefits of laparoscopy have delayed the development of this approach. Similarly to what is performed in classical resectional liver surgery, initial experiences of laparoscopy have therefore begun with left lateral sectionectomy, which is performed for adult to child living donation. In this setting, the laparoscopic technique is now well standardized, is associated with decreased donor blood loss and hospital stays and provides graft of similar quality compared to the open approach. On the other hand laparoscopic major right or left hepatectomies for adult-adult LDLT currently lack standardization and various techniques such as the full laparoscopic approach, the hand assisted approach and the hybrid approach have been reported. Hence, even-though several reports highlight the feasibility of these procedures, the true benefits of laparoscopy over laparotomy remain to be fully assessed. This could be achieved through standardization of the procedures and creation of international registries especially in Eastern countries where LDLT keeps on flourishing.

关键词： Liver transplantation Laparoscopy living donation Postoperative course

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Adipose tissue induces a better liver regeneration after living liver donation in normal weight donors

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Hepatobiliary Surgery and Nutrition 2023年第3期12卷 341-350页

作者： Aladdin Ali Deeb Utz Settmacher Michael Ardelt Felix Dondorf Oliver Rohland Falk Rauchfuß Department of General Visceral and Vascular SurgeryJena University HospitalJenaGermany

Background:Extrahepatic body fat could be a relevant factor affecting liver regeneration after partial *** aim of this study was to evaluate the potential role of body fatty tissue in liver regeneration capacity after liver resection in a cohort of living ***:We observed liver regeneration in 120 patients:70 living donors who underwent right hepatectomy and 50 recipients who got a right graft *** volumetry and body fat analysis were performed based on the computed tomography images with volumetry *** gain of liver volume was calculated between three points in time considering the absolute and percentage values:before surgery and early(median 10 days,range 4-21 days)and late(median 27 weeks,range 18-40 weeks)after ***’s correlation was used to examine the potential correlation between adipose tissue and liver ***:Pearson’s correlation showed a significant correlation between the subcutaneous fat mass index(sFMI)and early(r=0.173,P=0.030),as well late(r=0.395,P=0.0004)percental liver volume gain in the whole *** stratification in donor’s and recipient’s collectives,the effect of extrahepatic adipose tissue appears in multiple regression only in the donor’s collective:early(β=0.219,T=2.137,P=0.036)and late(β=0.390,T=2.552,P=0.015)percental volume ***:Subcutaneous adipose tissue is a positive predictive factor to estimate the goodness of liver regeneration after partial hepatectomy in normosthenic donors.

关键词： Partial hepatectomy fat mass index living donation liver transplantation

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Global dissemination of minimally invasive living donor hepatectomy: What are the barriers?

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World Journal of Gastrointestinal Surgery 2023年第5期15卷 776-787页

作者： Christos Dimitrios Kakos Angelos Papanikolaou Ioannis A Ziogas Georgios Tsoulfas Surgery Working Group Society of Junior DoctorsAthens 15123Greece Department of Transplant Surgery Aristotle University of ThessalonikiSchool of MedicineThessaloniki 54622Greece Department of Surgery Johns Hopkins University School of MedicineBaltimoreMD 21287United States Department of Surgery University of Colorado Anschutz Medical CampusAuroraCO 80045United States

Minimally invasive donor hepatectomy(MIDH)is a relatively novel procedure that can potentially increase donor safety and contribute to faster rehabilitation of *** an initial period in which donor safety was not effectively validated,MIDH currently seems to provide improved results,provided that it is conducted by experienced *** selection criteria are crucial to achieve better outcomes in terms of complications,blood loss,operative time,and hospital *** a pure laparoscopic technique,various approaches have been recommended such as hand-assisted,laparoscopic-assisted,and robotic *** latter has shown equal outcomes compared to open and laparoscopic approaches.A steep learning curve seems to exist in MIDH,mainly due to the fragility of the liver parenchyma and the experience needed for adequate control of *** review investigated the challenges and the opportunities of MIDH and the barriers to its global *** need expertise in liver transplantation,hepatobiliary surgery,and minimally invasive techniques to perform *** can be categorized into surgeon-related,institutionalrelated,and *** robust data and the creation of international registries are needed for further evaluation of the technique and the acceptance from more centers worldwide.

关键词： Minimally invasive donor hepatectomy Liver transplantation living donation Laparoscopic donor hepatectomy Global surgery

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Quality of life,depression and anxiety in potential living liver donors for pediatric recipients:A retrospective single center experience

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World Journal of Hepatology 2022年第10期14卷 1899-1906页

作者： Paula K Reine Flavia Feier Eduardo Antunes da Fonseca Rosely G Hernandes Joao Seda-Neto Department of Psychology Hospital Sirio-LibanesSao Paulo 01308901Brazil Department ofLiver Transplantation Santa Casa de Porto AlegrePorto Alegre 90020090Brazil Department of Liver Transplantation Hospital Sirio-LibanesSao Paulo 01308901Brazil

BACKGROUND living donor liver transplantation is a safe alternative for patients on a liver transplant *** evaluation goes beyond physical variables to include social,emotional,and ethical *** role of pre-donation sociopsychological evaluation of the donor candidate is as important to the success of the procedure as is the medical *** implies recovery from the operation and pro-mpt engagement in pre-transplant professional and social activities,without leading to psychological or physical *** profiling of potential living liver donors(PLLD)and evaluation of quality of life(QOL)can influence *** To evaluate the socio-demographics and psychological aspects(QOL,depression,and anxiety)of PLLD for pediatric liver transplantation in a cohort of 250 *** This was a retrospective cohort study of 250 PLLD who underwent psychological pre-donation evaluation between 2015 and *** the recipients were *** Beck anxiety inventory,Beck depression inventory,and 36-item short-form health survey(SF-36)scores were used to evaluate anxiety(Beck anxiety inventory),depression(Beck depression inventory),and QOL,*** A total of 250 PLLD were *** of them were women(54.4%),and the mean age was 29.2±7.2 years.A total of 120(48.8%)PLLD were employed at the time of evaluation for donation;however,most had low income(57%earneddonation process,and 247 PLLD answered a questionnaire to evaluate depression,anxiety,and QOL(SF-36).Prevalence of depression was of 5.2%and anxiety 3.6%.Although most of the PLLD were optimistic regarding the donation process and never had doubts about becoming a donor,some traces of ambivalence were observed:46%of the respondents said they would feel relieved if a deceased donor became *** PLLD had a low prevalence of anxiety and *** foundation for effective and sa

关键词： Liver transplantation Children Outcomes living donation

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Successful living donor liver transplantation in a cystic fibrosis patient with combined hepatocellular carcinoma and cholangiocarcinoma

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Hepatoma Research 2015年第1期1卷 46-48页

作者： Falk Rauchfuß Felix Dondorf RenéFahrner Michael Ardelt Yves Dittmar Utz Settmacher Department of General Visceral and Vascular SurgeryJena University HospitalFriedrich-Schiller-University Jena07747 JenaGermany

Combined hepatocellular carcinoma(HCC)and cholangiocarcinoma(CC)is a rare tumor *** this report,we describe a case of a young patient who developed a liver tumor in a cirrhotic liver caused by cystic fi *** diagnostic fi ndings suggested that this tumor was an *** performed living donor liver *** examination of the tumor revealed combined HCC and CC as an incidental fi *** years after the transplantation,the patient is in good clinical condition and is disease-free.

关键词： Cholangiocarcinoma cystic fi brosis hepatocellular carcinoma liver transplantation liver tumor living donation

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