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

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.