To investigate the application value of total laparoscopic hepatectomy in donor live procurement of left lateral living donor liver transplantation.

Clinical data of two donors who underwent total laparoscopic living donor liver procurement of left lateral lobe in Huashan Hospital affliated to Fudan University between October 2016 and November 2016 were retrospectively analyzed. Case 1, the donor was a 27-year-old female, and the recipient was diagnosed with congenital biliary atresia. The donor and the recipient were in mother-child relationship. The predicted graft recipient weight ratio (GRWR) was 3.2%. Case 2, the donor was a 26-year-old male, and the recipient was diagnosed with congenital bile acid synthesis defect. The donor and recipient were in father-child relationship. The predicted GRWR was 2.1%. The informed consents of both donors were obtained and the local ethical committee approval was received. Both donors underwent total laparoscopic living donor liver procurement of left lateral lobe. The left hepatic artery, left portal vein and left hepatic vein were dissected and cut, and the liver specimen was collected via the small suprapubic incision.

The surgery was successfully performed in both donors. The operation time was respectively 190 and 210 min. The intraoperative blood loss was respectively 100 and 60 ml. No blood transfusion was performed intraoperatively. The actual GRWR was respectively 3.1% and 1.8%. The postoperative liver function of both donors recovered smoothly, and no bile leakage, poor wound healing or other postoperative complications were observed. They were discharged from hospital at postoperative 1 week and were followed up, and no abnormality was observed in the donors till the manuscript submission date. The liver function of the recipients recovered smoothly and mainly returned to normal within 2 weeks. No obvious graft-related complications were observed during the follow-up.

Total laparoscopic living donor liver procurement of left lateral lobe can effectively alleviate the injury of the donors and has no adverse effects on the liver graft, which is a safe and feasible technique for donor liver procurement.