Impact of thoracic shape on the surgical outcomes of laparoscopic‐assisted living donor hepatectomy

TL;DR

This study shows that donor thoracic shape, especially depth, affects surgical outcomes in laparoscopic liver donation, with deeper chests linked to more blood loss.

Contribution

The study identifies thoracic depth as a novel predictor of blood loss and operation time in laparoscopic donor hepatectomy.

Findings

Greater thoracic depth is associated with increased blood loss and longer operation time.

Blood loss >500 mL is linked to graft weight in left- and thoracic depth in right-lobes.

Anthropometric parameters can help estimate surgical outcomes and improve preoperative planning.

Abstract

Although laparoscopic‐assisted donor hepatectomy (LADH) has become the definitive procedure for harvesting living donor livers, its surgical outcomes in association with donor body shape have not been elucidated.

The impact of donor factors, including thoracic shape, on LADH outcomes was retrospectively investigated. Thoracic anthropometric data were examined in all LADHs with a left/right graft between 2013 and 2022.

The study included 210 LADHs, consisting of 106 left‐ and 104 right‐lobe donors with similar blood loss and similar operation time. Males have greater thoracic depth and greater thoracic width compared with females, respectively. Thoracic depth was associated with graft weight (p < 0.001), blood loss (p < 0.001), and operation time (p < 0.001). On multivariate analyses, blood loss >500 mL and operation time >8 h were associated with graft weight in the left‐lobe donors, and blood loss >500 mL was associated with thoracic depth in the right‐lobe donors.

The greater thoracic depth is associated with massive blood loss in right‐lobe donors. Anthropometric parameters might be helpful for estimating LADH outcomes.

A greater thoracic depth contributes to blood loss >500 mL in right‐lobe donors. This anthropometric parameter is helpful for estimating LADH outcomes and should be considered in preoperative planning to ensure the highest safety of living donor hepatectomy.

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