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Surgical Endoscopy
Published in: Surgical Endoscopy 11/2015

01-11-2015 | Review

Donor safety in live donor laparoscopic liver procurement: systematic review and meta-analysis

Authors: Mohamed Bekheit, Philipe-Abrahim Khafagy, Petru Bucur, Khaled Katri, Ahmed Elgendi, Wael Nabil Abdel-salam, Eric Vibert, El-said El-kayal

Published in: Surgical Endoscopy | Issue 11/2015

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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.
Appendix
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Metadata
Title
Donor safety in live donor laparoscopic liver procurement: systematic review and meta-analysis
Authors
Mohamed Bekheit
Philipe-Abrahim Khafagy
Petru Bucur
Khaled Katri
Ahmed Elgendi
Wael Nabil Abdel-salam
Eric Vibert
El-said El-kayal
Publication date
01-11-2015
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 11/2015
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-014-4045-1

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