Laparoscopic Approach for Living Donor to Paediatric Liver Transplantation. A Single Centre Experience of the First 5 Cases in Spain

Background: An experience from a single Liver Paediatric Transplant Center is presented. Our program has performed more than 170 children's liver transplants. In the last year, the laparoscopic approach has been introduced in this surgery. Methods: In this study we report our series of five cases of living donor liver transplantation (LDLT), one of them auxiliary, performing left lateral sectorectomy with a pure laparoscopic approach performed in 2016. Results: The average age of donors was 32.4±3,9 (27-37) years.The mean BMI of the donors was 22.8±3,9 (18.38-27.47). 60% were ASA I and 40% ASA II. Only two donors required Pringle maneuver. The mean age of the recipients was 3.2±4,9 (4-12) months with an average weight of 12.6±10,5 (6,6-31) kg. The aetiology was biliary atresia in 3 of them and metabolic disorders in the other two. The type of graft in the five cases were left lateral sectorectomy (LLS). The surgical time of donor surgery was 386 ± 25.1 (360-410) min and the recipient's time was 439 ± 87.5 (315-560) min.The conversion rate was 0%.The recipient CCI of our series was 15.1 ± 14.7. The mean stay of the recipients was 22.8 ± 7.9 (14-33) days and the donors was 4.4 ± 1.5 (3-6) days. Conclusion: We can propose the laparoscopic approach in reference centers as “gold standard” due to its minimal complication rate and short hospital stay,performed in specialized centers