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01-02-2022 | Liver Transplantation | Review Article

The impact of mini-invasive right hepatectomy in the setting of living donation: a meta-analysis

Authors: Quirino Lai, Francesco Giovanardi, Gianluca Mennini, Giammauro Berardi, Massimo Rossi

Published in: Updates in Surgery | Issue 1/2022

Abstract

Adult-to-adult living-donor liver transplantation (A2ALDLT) represents a challenging procedure, mainly when the right hepatic lobe is donated. Therefore, especially in Western countries, the medical community still considers it a “risky procedure”. The present meta-analysis investigated the postoperative results reported in donors undergoing right hepatectomy for A2ALDLT through a minimally invasive liver resection (MILR) vs. open liver resection (OLR) approach, with the intent to clarify the hypothesis that the MILR approach should minimize the risks for the donor. A systematic literature search was performed using MEDLINE-PubMed, Cochrane Library, and EMBASE electronic databases. The primary outcome investigated was the complication rate after transplant. Fifteen studies were included (n = 2094; MILR = 553 vs. OLR = 1541). The MILR group only merged the statistical relevance in terms of advantage in terms of a lower number of complications (OR = 0.771, 95% CI 0.578–1.028; P value = 0.077). Investigating the complications ≥ IIIa according to the Dindo-Clavien classification, the estimated blood loss, and the length of hospital stay, no statistical difference was reported between the two groups. MILR represents a novel and promising approach for improving the results in A2ALDLT. However, no benefits have been reported regarding blood loss, length of stay, and postoperative complications. More extensive experiences are needed to re-evaluate the impact of MILR in right lobe live donation.

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Title: The impact of mini-invasive right hepatectomy in the setting of living donation: a meta-analysis
Authors: Quirino Lai
Francesco Giovanardi
Gianluca Mennini
Giammauro Berardi
Massimo Rossi
Publication date: 01-02-2022
Publisher: Springer International Publishing
Keywords: Liver Transplantation
Liver Resection
Liver Resection
Liver Transplantation
Liver Transplantation
Liver Transplantation
Liver Transplantation
Published in: Updates in Surgery / Issue 1/2022
Print ISSN: 2038-131X
Electronic ISSN: 2038-3312
DOI: https://doi.org/10.1007/s13304-021-01160-x

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The impact of mini-invasive right hepatectomy in the setting of living donation: a meta-analysis

Abstract

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Abstract

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