title: Donor safety in live donor laparoscopic liver procurement: systematic review and meta-analysis.
abstract: BACKGROUND
  Donor safety is a major concern in live organ donation. Live donor laparoscopic liver procurement is an advanced surgical procedure that is performed in highly specialized centers. Since its first report, not much progress has been endeavored for that procedure.
  
  
  METHODS
  We planned to include all the randomized and comparative nonrandomized studies. Patients' population: live donors who are submitted to organ procurement via laparoscopy.
  
  
  RESULTS
  Out of 5,636 records retrieved from the literature, only seven nonrandomized studies were included in this review, which encompassed 418 patients, 151 patients of whom underwent laparoscopic procurement. The quality scores for the included studies ranged from 66 to 76 %. The operative time was significantly shorter in the conventional open group (SD = 0.863, 95 % CI 0.107-1.819). Blood loss in the laparoscopic group was comparable with the conventional open approach (SD = -0.307, 95 % CI -0.807 to 0.192). In subgroup analysis, laparoscopy was protective against blood loss in laparoscopic parenchymal dissection (SD = -1.168, 95 % CI -1.758 to -0.577). The hospital stay was equal in both groups. Patients in laparoscopic group consumed fewer analgesics compared with conventional open group (SD = -0.33, 95 % CI -0.63 to -0.03). Analgesics use was lower in the laparoscopic group compared with the conventional approach. The rate of Clavien complications was equal in both groups (OR 0.721, 95 % CI 0.303-1.716). No difference was found between subgroup analysis based on the harvested liver lobe. Funnel plot and statistical methods used revealed low probability of publication BIAS.
  
  
  CONCLUSIONS
  Live donor laparoscopic liver procurement could be as safe as the conventional open approach. Lower blood loss and lower consumtion of analgesics might be offered in the laparoscopic approach.
authors.affiliation: Minimal Invasive Surgery Unit, Department of Surgery, El Kabbary General Hospital, El Kabbary, Alexandria, Egypt. dr_mohamedbekheit@hotmail.com.|CIRE Plateform, INRA Centre Val de Loire, 37380, Nouzilly, France. dr_mohamedbekheit@hotmail.com.|INSERM, Unit 785, Centre Hepatobiliaire, Paul Brousse Hospital, 94804, Villejuif, France. dr_mohamedbekheit@hotmail.com.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Bekheit
authors.affiliation: Department of Radiology, Le Raincy-Montfermeil Hospital, 93370, Monfermeil, France.
authors.forename: Philipe-Abrahim
authors.initials: PA
authors.lastname: Khafagy
authors.affiliation: INSERM, Unit 785, Centre Hepatobiliaire, Paul Brousse Hospital, 94804, Villejuif, France.
authors.forename: Petru
authors.initials: P
authors.lastname: Bucur
authors.affiliation: HPB Surgery Unit, Department of Surgery, Faculty of Medicine, Alexandria Main University Hospitals, Alexandria University, Alexandria, Egypt.
authors.forename: Khaled
authors.initials: K
authors.lastname: Katri
authors.affiliation: HPB Surgery Unit, Department of Surgery, Faculty of Medicine, Alexandria Main University Hospitals, Alexandria University, Alexandria, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Elgendi
authors.affiliation: HPB Surgery Unit, Department of Surgery, Faculty of Medicine, Alexandria Main University Hospitals, Alexandria University, Alexandria, Egypt.
authors.forename: Wael Nabil
authors.initials: WN
authors.lastname: Abdel-Salam
authors.affiliation: INSERM, Unit 785, Centre Hepatobiliaire, Paul Brousse Hospital, 94804, Villejuif, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Vibert
authors.affiliation: HPB Surgery Unit, Department of Surgery, Faculty of Medicine, Alexandria Main University Hospitals, Alexandria University, Alexandria, Egypt.
authors.forename: El-Said
authors.initials: el-S
authors.lastname: El-Kayal
mesh_terms: D006801:Humans; D010535:Laparoscopy; D016031:Liver Transplantation; D019520:Living Donors; D009392:Nephrectomy / Q000379:methods*; D061214:Patient Safety; D020858:Tissue and Organ Harvesting / Q000379:methods*
keywords: Abdominal; Digestive; Hepatobiliare (liver); Laparoscopic; Live donor; Liver transplantation; Surgical; Transplantation