Korean J Transplant.  2022 Nov;36(Supple 1):S39. 10.4285/ATW2022.F-1437.

Donor safety and risk factors of pure laparoscopic living donor right hepatectomy: a Korean multicenter study

• Kim SH
• Kim KH

• KMID: 2535211
• DOI: http://doi.org/10.4285/ATW2022.F-1437

Abstract

Background
The aim was to analyze safety and risk factors of living donor after pure laparoscopic donor right hepatectomy (PLRDH) in a Korean multicenter cohort study.
Methods
This retrospective study included 543 patients undergoing PLRDH between 2010 and 2018 in five Korean transplan-tation centers. Rate of complication based on Clavien-Dindo classification was assessed and multivariate logistic regression analyses were performed to identify risk factors of overall complications, major complications, biliary complications, and open conversion.
Results
Overall complication, major complication (Clavien-Dindo classification III and IV), and biliary complication rate were 7.9%, 5.3%, and 3.3% respectively. For overall complication, risk factors were graft weight >680 g (P=0.017; odds ratio [OR], 2.35; 95% confidence interval [CI], 1.17–4.71), estimated blood loss (P<0.001; OR, 4.88; 95% CI, 2.52–9.45), and operation time >400 minutes (P=0.01; OR, 2.45; 95% CI, 1.24–4.85). For major complication, risk factor was graft weight >680 g (P=0.026; OR, 3.37; 95% CI, 1.16–9.83). For biliary complications, risk factor was graft weight >680 g (P=0.019; OR, 4.84; 95% CI, 1.30–17.97). For open conversion, risk factors were BMI >30 kg/m 2 (P=0.006; OR, 11.08; 95% CI, 2.01–60.97) and operation time >400 minutes (P=0.036; OR, 4.24; 95% CI, 1.10–16.40).
Conclusions
Careful donor selection for PLRDH considering graft weight, high BMI, operation time, and estimated blood loss combined with skilled procedure can minimizes the risk of complications.