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Left lobe living donor liver transplantation using the resection and partial liver segment 2–3 transplantation with delayed total hepatectomy (RAPID) procedure in cirrhotic patients: First case report in Korea
Ann Hepatobiliary Pancreat Surg
Published online April 1, 2024;  https://doi.org/10.14701/ahbps.24-005
Copyright © 2024 The Korean Association of Hepato-Biliary-Pancreatic Surgery.

Jongman Kim*, Jinsoo Rhu*, Eunjin Lee, Youngju Ryu, Sunghyo An, Sung Jun Jo, Namkee Oh, Seungwook Han, Sunghae Park, Gyu-Seong Choi

Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Correspondence to: Jongman Kim, MD, PhD
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
Tel: +82-2-3410-1719, Fax: +82-2-3410-0040, E-mail: yjongman21@gmail.com
ORCID: https://orcid.org/0000-0002-1903-8354

*These authors contributed equally to this study.
Received January 5, 2024; Revised February 24, 2024; Accepted February 28, 2024.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
In liver transplantation, the primary concern is to ensure an adequate future liver remnant (FLR) volume for the donor, while selecting a graft of sufficient size for the recipient. The living donor–resection and partial liver segment 2−3 transplantation with delayed total hepatectomy (LD−RAPID) procedure offers a potential solution to expand the donor pool for living donor liver transplantation (LDLT). We report the first case involving a cirrhotic patient with autoimmune hepatitis and hepatocellular carcinoma, who underwent left lobe LDLT using the LD−RAPID procedure. The living liver donor (LLD) underwent a laparoscopic left hepatectomy, including middle hepatic vein. The resection on the recipient side was an extended left hepatectomy, including the middle hepatic vein orifice and caudate lobe. At postoperative day 7, a computed tomography scan showed hypertrophy of the left graft from 320 g to 465 mL (i.e., a 45.3% increase in graft volume body weight ratio from 0.60% to 0.77%). After a 7-day interval, the diseased right lobe was removed in the second stage surgery. The LD−RAPID procedure using left lobe graft allows for the use of a small liver graft or small FLR volume in LLD in LDLT, which expands the donor pool to minimize the risk to LLD by enabling the donation of a smaller liver portion.
Keywords : Living donor; Tissue and organ procurement; Directed tissue donation; Transplantation