Postoperative outcomes of living donor hepatectomy

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Record number: 
Adverse Occurrence type: 
MPHO Type: 
Estimated frequency: 
Living liver donors undergoing open (OP, n=1390) or minimally invasive (MI, n=277 laparoscopic and n=27 robotic) hepatectomy. Post operative complication frequency was 3,5% in OP group vs 6,2% in MI group. Major complication (Claien-Dindo rate 3 or higher: requiring surgival, endoscopic or radiological intervention) was 2% in both groups. Class 3b complications (requiring general anaesthesia) was higher in MI group.
Time to detection: 
Majority within 7 days of initial surgery; in both groups 0,3% of complications was detected one year post donation
Alerting signals, symptoms, evidence of occurrence: 
Clinical symptoms indicating for the most coming complications in both groups were [1] biliary complications, including bile leak and stricture, [2] rates of bleeding, vascular complications and [3] wound healing problems.
Demonstration of imputability or root cause: 
Postoperative complications were merely seen when donors had undergone right lobectomy without middle hepatic vein (overall 279/1201, n=19 in MI group and n=47in OP group)
Imputability grade: 
3 Definite/Certain/Proven
Groups audience: 
Reference attachment: 
Suggest references: 
A comparative study of postoperative outcomes between minimally invasive living donor hepatectomy and open living donor hepatectomy: The Korean organ transplantation registry. Surgery. 2021 Jul;170(1):271-276
Expert comments for publication: 
In general donors might expect to experience more discomfort from open surgery (OP) compared to minimal invasive (MI) surgery. Although both methods show low complication rates, surprisingly the open method does slightly better. Serious complications after living donor liver transplantation lead to subsequent medical interventions and require longer hospital admission. More experience with minimal invasive procedures will probably lead to better outcome and less complications.