title: Donor hepatectomy using hanging maneuvers: Tokyo University experiences in 300 donors.
abstract: OBJECTIVE
  The liver hanging maneuver (LHM) is a widely used novel suspending technique for facilitating liver transection. However, little evidence is available to reveal its safety and true advantages in donor operations for living donor liver transplantation (LDLT).
  
  
  METHODS
  The medical records of 422 consecutive living donors at a single institute were reviewed. The feasibility and outcomes of the use of LHM in donor operation for LDLT were investigated.
  
  
  RESULTS
  Two types of hanging maneuvers, namely, Belghiti's conventional method and a modified approach where the sling is placed after full mobilization of the liver, have been routinely adopted selectively since 2000, and to date, 304 LHM have been carried out. Marked reduction in the liver transection time needed for harvesting a hemiliver graft has been obtained after the introduction of LHM (p<0.0001). No major complications associated with the LHM have been recorded. Comparison of the conventional and modified LHM revealed similar outcomes for the two, except that the modified approach required a longer liver dissection time (81 vs. 98 min; p=0.0004).
  
  
  CONCLUSIONS
  Considering its high feasibility and several advantages in facilitating liver transection, LHM might be worth attempting in donor operations where a major hepatectomy is required.
authors: Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, Universityof Tokyo, Tokyo, Japan.
authors: Junichi
authors: J
authors: Shindoh
authors: Taku
authors: T
authors: Aoki
authors: Kiyoshi
authors: K
authors: Hasegawa
authors: Yoshifumi
authors: Y
authors: Beck
authors: Yasuhiko
authors: Y
authors: Sugawara
authors: Masatoshi
authors: M
authors: Makuuchi
authors: Norihiro
authors: N
authors: Kokudo
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D005240:Feasibility Studies; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000379:methods*; D014041:Tokyo; D016896:Treatment Outcome