Laparoscopic-assisted full-sized liver transplantation with magnetically fast portal vein anastomosis: An initial cohort study

Background: Some cases of laparoscopic-assisted liver transplantation (LA-LT) with utilization of reduced-size grafts has been reported. The authors here introduced successful utilization of LA-LT with whole liver grafts and magnetic portal vein anastomosis. Methods: Eight patients with liver cirrhosis were included for LA-LT using donor organs after cardiac death. The surgical procedures included purely laparoscopic explant hepatectomy and whole-liver graft implantation via the midline incision. After explant removal, the whole-liver graft was then placed in situ, and a side-to-side cavo-caval anastomosis with 4–5 cm oval opening was performed. The magnetic rings were everted on the donor and recipient portal vein, respectively, and the instant attachment of the two magnets at the donor and recipient portal vein allowed fast blood reperfusion, followed by continuous suturing on the surface of the magnets. Results: The median operation time was 495 (range 420–630). The median time of explant hepatectomy and inferior vena cava anastomosis was 239 (range 150–300) min and 14.5 (range 10–19) min, respectively. Of note, the median anhepatic time was 25 (range 20–35) min. All the patients were discharged home with no major complications after more than 12 months follow-up. Conclusion: LA-LT with full-size graft is feasible and utilization of magnetic anastomosis would further simplify the procedure.