Laparoscopic living donor hepatectomy for liver transplantation in children.
BACKGROUND
Because cadaveric organ donors are in short supply, living donors are increasingly being used in transplantations. We have developed a safe and reproducible method for laparoscopic liver resection.


METHODS
Left hepatic lobectomy (resection of segments 2 and 3) was done by laparoscopy in one woman aged 27 years and one man aged 31 years. The grafts were prepared under laparoscopy, without any vascular clamping, and were externalised through a suprapubic Pfannenstiel incision. Both grafts were transplanted conventionally to the patients' respective sons, who were both aged 1 year and had biliary atresia.


RESULTS
Donor operations lasted 7 h for the woman and 6 h for the man, and warm ischaemia times were 4 and 10 min, respectively. Blood loss was 150 and 450 mL, respectively, and no transfusions were required. Neither patient had complications during or after surgery; and hospital stay was 7 and 5 days, respectively. Both recipients are alive and have excellent graft function.


CONCLUSIONS
We have shown the feasibility of laparoscopic living donor hepatectomy from parent to child. If the safety and feasibility of this procedure can be shown in larger series, laparoscopic donor left lobectomy could become a new option for paediatric living donor liver transplantation.
Cherqui
Daniel
D
Department of General and Digestive Surgery, Hôpital Henri Mondor 94010, Créteil, France. daniel.cherqui@hmn.ap-hop-paris.fr
Soubrane
Olivier
O
Husson
Emmanuel
E
Barshasz
Eric
E
Vignaux
Olivier
O
Ghimouz
Mourad
M
Branchereau
Sophie
S
Chardot
Christophe
C
Gauthier
Frédéric
F
Fagniez
Pierre Louis
PL
Houssin
Didier
D
D000328:Adult; D001656:Biliary Atresia / Q000601:surgery; D005260:Female; D006085:Graft Survival; D006801:Humans; D007223:Infant; D010535:Laparoscopy; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male