Laparoscopic-assisted liver transplantation: A realistic perspective.
Am J Transplant
; 22(12): 3069-3077, 2022 12.
Article
in En
| MEDLINE
| ID: mdl-35704274
ABSTRACT
Laparoscopic approach was rarely described in recipients for liver transplantation (LT). We report the feasibility and safety of laparoscopic-assisted LT (LA-LT) in patients with unresectable liver metastases of neuroendocrine tumors. Total hepatectomy was performed laparoscopically with graft implantation through an upper midline incision. Liver grafts were retrieved from deceased donors. From July 2019 to July 2021, six patients (4 women, 2 men) underwent LA-LT. Median age and BMI were 46 (29-54) and 24 (19-35) kg/m2 , respectively. Implanted grafts were reduced (n = 3), full (n = 2), and a right split liver (n = 1). Median surgical time was 405 min (390-450) and median blood loss was 425 ml (250-600). Median cold and warm ischemia times were 438 min (360-575) and 35 min (30-40), respectively. Median anhepatic phase was 51 min (40-67) and midline incision was 14 cm (13-20) long. On postoperative day 5, median prothrombin index and serum bilirubin levels were 95% (70-117) and 11 (10-37) µmol/L, respectively. No Clavien-Dindo > III complications were encountered. Median hospital stay was 12 days (10-14). After a median follow-up of 8 (8-32) months, all patients were alive without tumor recurrence or adverse event. This preliminary series suggests that in selected patients, LA-LT is a safe and effective option.
Key words
Full text:
1
Database:
MEDLINE
Main subject:
Liver Transplantation
/
Laparoscopy
Type of study:
Etiology_studies
/
Observational_studies
Limits:
Female
/
Humans
/
Male
Language:
En
Journal:
Am J Transplant
Journal subject:
TRANSPLANTE
Year:
2022
Type:
Article
Affiliation country:
France