Topic Highlight
Copyright ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Oct 14, 2013; 19(38): 6353-6359
Published online Oct 14, 2013. doi: 10.3748/wjg.v19.i38.6353
Right hepatic lobe living donation: A 12 years single Italian center experience
Salvatore Gruttadauria, Duilio Pagano, Davide Cintorino, Antonio Arcadipane, Mario Traina, Riccardo Volpes, Angelo Luca, Giovanni Vizzini, Bruno Gridelli, Marco Spada
Salvatore Gruttadauria, Duilio Pagano, Davide Cintorino, Antonio Arcadipane, Mario Traina, Riccardo Volpes, Angelo Luca, Giovanni Vizzini, Bruno Gridelli, Marco Spada, Istituto Mediterraneo Trapianti e Terapie ad Alta Specializzazione, University of Pittsburgh Medical Center in Italy, 90127 Palermo, Italy
Salvatore Gruttadauria, Davide Cintorino, Bruno Gridelli, Marco Spada, Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, United States
Author contributions: Gruttadauria S was based on drafting the article critically for important intellectual content; Pagano D, Cintorino D, Arcadipane A, Traina M, Volpes R, Luca A and Vizzini G were also involved in editing the manuscript; Spada M and Gridelli B were involved for designing the study and giving the final approval of the version to be published.
Correspondence to: Salvatore Gruttadauria, MD, Associate Professor of Surgery, Istituto Mediterraneo Trapianti e Terapie ad Alta Specializzazione, University of Pittsburgh Medical Center in Italy, Via Tricomi 1, 90127 Palermo, Italy. sgruttadauria@ismett.edu
Telephone: +39-9-12192111 Fax: +39-9-12192400
Received: July 17, 2013
Revised: August 21, 2013
Accepted: August 28, 2013
Published online: October 14, 2013
Processing time: 90 Days and 15 Hours
Abstract

Mini invasive techniques are taking over conventional open liver resections in the setting of left lateral segmentectomy for living liver donation, and hydride procedure are being implemented for the living related right hepatectomy. Our center routinely performs laparoscopic left lateral segmentectomy for pediatric recipient and has been the first in the Europe performing an entirely robotic right hepatectomy. Great emphasis is posed on living donor safety which is the first priority during the entire operation, then the most majority of our procedures are still conventional open right hepatectomy (RHLD), defined as removal of a portion of liver corresponding to Couinaud segments 5-8, in order to obtain a graft for adult to adult living related liver transplant. During this 10 years period some changes, herein highlighted, have occurred to our surgical techniques. This study reports the largest Italian experience with RHLD, focused on surgical technique evolution over a 10 years period. Donor safety must be the first priority in right-lobe living-related donation: the categorization of complications of living donors, specially, after this “highly sensitive” procedure, reflects the need for prompt and detailed reports.

Keywords: Adult-to-adult living-related liver transplantation; Liver regeneration; Liver resections; Liver transplantation; Liver surgery

Core tip: A 12 years Italian single center experience is herein reported, focusing on the live donors who underwent conventional open right hepatectomies for adult to adult living related liver transplantations. In light of this experience we individualized three area of interest where we accomplished remarkable goals over this time period: donor nutritional status and rescue of steatotic donors; analysis of post hepatectomy liver regeneration; surgical technical developments.