Cleveland Clinic's first purely laparoscopic living donor surgery for liver transplant

Cleveland Clinic has successfully performed the Midwest's first purely laparoscopic living donor surgery for liver transplantation in an adult recipient. The advanced procedure is available at only a few hospitals worldwide, and Cleveland Clinic is the second U.S. academic medical center to offer this approach for living donor liver transplantation.

Unlike open surgery that requires a large incision to access the liver, the laparoscopic procedure is performed with surgical tools and a camera inserted through a few half-inch holes in the abdomen of the living donor. Once the piece of the liver is dissected, the surgeon retrieves the graft through a small incision below the navel. The minimally invasive technique benefits the living donor, who experiences better postoperative recovery and a quicker return to normal life, less pain, smaller scars, and lower risk of an incisional hernia compared with traditional open surgery.

About five percent of people who undergo a liver transplant receive the organ from a living donor who has made the altruistic decision to give up a portion of their liver to save someone else's life. The liver is the only organ that can regenerate, which makes it possible for a living person to donate a portion of their liver. It can take six to eight weeks for a healthy liver to grow back to its original size.

On August 19, Choon Hyuck David Kwon, M.D., Ph.D., director of Laparoscopic Liver Surgery at Cleveland Clinic's Digestive Disease & Surgery Institute, led a team of surgeons and nurses during the minimally invasive procedure that extracted a third of the liver from a 29-year-old living donor.

In an adjacent operating room, Koji Hashimoto, M.D., Ph.D., Cleveland Clinic's director of Living Donor Liver Transplantation, and his team received the donated segment of the liver and performed the transplant in a 66-year-old recipient. Due to an irreversible liver disease called cryptogenic cirrhosis, the recipient was suffering from life-threatening complications and needed a liver transplant.

Dr. Kwon specializes in minimally invasive liver surgery and living donor liver transplantation. In 2013, he merged both areas of expertise and started performing purely laparoscopic living donor surgeries for liver transplantation in pediatric and adult recipients.