AUTHOR=Rastogi Amit , Gupta Ankur A. , Bansal Raghav , Kollanta Valappil Fysal , Yadav Kamal S. , Chaudhary Suchet , Bhangui Prashant , Dhampalvar Swapnil , Choudhary Narendra S. , Saraf Neeraj , Soin Arvinder S. 

TITLE=Minimizing Incision in Living Donor Liver Transplantation: Initial Experience and Comparative Analysis of Upper Midline Incision in 115 Recipients

JOURNAL=Transplant International

VOLUME=Volume 37 - 2024

YEAR=2024

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2024.12536

DOI=10.3389/ti.2024.12536

ISSN=1432-2277

ABSTRACT=Living donor liver transplantation (LDLT) needs "Mercedes Benz" or "J-shaped" incision, causing short and long-term complications. An upper midline incision (UMI) is less invasive alternative but technically challenging. Reporting UMI for recipients in LDLT vs conventional J-shaped incision.
Retrospective analysis, July 2021 to December 2022. Peri-operative details and post-transplant outcomes of 115 consecutive adult LDLT recipients transplanted with UMI compared with 140 recipients with J-shaped incision.
Cohorts had similar preoperative and intraoperative variables. The UMI group had significant shorter time to ambulation (3 ± 1.6 vs 3.6 ± 1.3, p = 0.001), ICU stay (3.8 ± 1.3 vs 4.4 ± 1.5 days, p = 0.001), but a similar hospital stay (15.6±7.6 vs 16.1±10.9, p = 0.677), lower incidence of pleural effusion (11.3% vs 27.1% p = 0.002), and post-operative ileus (1.7% vs 9.3% p = 0.011). The rates of graft dysfunction (4.3% vs 8.5% p = 0.412), biliary complications (6.1% vs 12.1% p = 0.099), 90-day mortality (7.8% vs 12.1% p = 0.598) were similar.
UMI-LDLT afforded benefits such as reduced pleuropulmonary complications, better early post-operative recovery and reduction in scar-related complaints in the medium-term. This is a safe, noninferior and reproducible technique for LDLT.