The Current State of Minimally Invasive Living Donor Hepatectomy
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LIVER TRANSPLANTATION (D MULLIGAN AND R BATRA, SECTION EDITORS)
The Current State of Minimally Invasive Living Donor Hepatectomy Dustin Carpenter 1,2
&
Sulemon Chaudhry 1,2 & Benjamin Samstein 1,2,3
# Springer Nature Switzerland AG 2020
Abstract Purpose of Review To evaluate the current state of minimally-invasive living donor hepatectomy by briefly summarizing its history, examining up-to-date technical considerations, reviewing important recently published reports, and discussing the path forward to continued progress. Recent Findings The last several years have seen a surge in reports of purely laparoscopic major donor hepatectomy. These accounts span several continents and include updates from centers with significant experience. Other studies come as case reports or small case series from centers just developing their minimally invasive expertise. There are now centers that perform purely laparoscopic donor hepatectomies with no donor selection criteria with equivalent outcomes compared with conventional hepatectomy. However, even these centers continue to urge caution in donors with complex variant anatomy. Summary Rapid growth in minimally invasive donor hepatectomy has developed within the past decade. There is no single technique adopted by all centers, and regional and center-specific preferences continue to exist. Equivalent outcomes can be achieved with appropriate donor selection that matches center expertise. Despite continued progress, pure laparoscopic living donor hepatectomy should remain available only in highly specialized centers. Aggressive efforts should be made to transfer knowledge, skills, and expertise to centers transitioning to more minimally invasive approaches. Keywords Living donor liver transplant . Minimally invasive hepatectomy . Laparoscopic hepatectomy . Laparoscopic-assisted hybrid hepatectomy . Donor hepatectomy
Introduction Nearly 60 years after the first reported liver transplant, hundreds of thousands of patients have benefited from life-saving liver transplantation, firmly establishing it as the treatment of choice for end-stage liver disease. However, after its inception This article is part of the Topical Collection on Liver Transplantation Electronic supplementary material The online version of this article (https://doi.org/10.1007/s40472-020-00287-x) contains supplementary material, which is available to authorized users. * Benjamin Samstein [email protected] 1
Department of Surgery, Division of Hepatobiliary Surgery and Liver Transplantation, New York – Presbyterian Hospital, Weill-Cornell Medical Center, New York, NY, USA
2
Department of Surgery, Division of Transplantation, New York – Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA
3
Weill Cornell Medicine, 525 East 68th Street, Payson 707, New York, NY 10065, USA
challenges soon arose in the face of a mounting organ shortage, and in response to high wait-list mortality—especially in the pediatric population—living donor liver transplant (LDLT) became a viable path to t
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