Abstract

Background: Laparoscopic donor hepatectomy has been increasingly adopted worldwide, particularly for pediatric liver transplantation using left-sided grafts. However, data from developing countries remain limited.

Methods: A retrospective cohort study was conducted on 21 living donors who underwent laparoscopic left-sided donor hepatectomy at University Medical Center Ho Chi Minh City between May 2024 and December 2025. Donor characteristics, graft features, intraoperative outcomes, and postoperative recovery were analyzed.

Results: Among 21 donors, left lateral section grafts accounted for 76.2% and full left grafts for 23.8%. The median donor age was 30 (25-58) years, with a median BMI of 21.9 (16.6-26.0) kg/m². Median graft volume was 211.0 (154.0-488.0) mL, and GRWR was 2.1 (1.1-3.9) %.  The median operative time was 320 (224-420) minutes, with a median warm ischemia time of 7.8 (5.0-12.0) minutes and blood loss of 150 (100-300) mL. No conversion to open surgery or blood transfusion was required. The median hospital stay was 6 (4-7) days. Liver function recovered well postoperatively. Major complications (Clavien-Dindo ≥ IIIa) occurred in 4.7% of cases, with no mortality.

Conclusions: Preliminary results suggest that laparoscopic left-sided donor hepatectomy for pediatric liver transplantation is a feasible and safe procedure when performed in experienced centers. However, further studies with larger sample sizes are needed to evaluate the potential for standardization and wider implementation of this technique.