BACKGROUND
Pure laparoscopic donor hepatectomy (PLDH) is increasingly adopted in living donor liver transplantation (LDLT) to enhance donor recovery. However, evidence on long-term health-related quality of life (HRQoL) following PLDRH is scarce, particularly in low-volume centers. This study aimed to compare perioperative outcomes and longitudinal HRQoL between PLDH and conventional open donor hepatectomy (CODH) in a single low-volume LDLT center.
MATERIAL AND METHODS
A retrospective cohort study was conducted between March 2010 and July 2023, including 50 living liver donors who underwent donor hepatectomy (27 CODH; 23 PLDH). Donor demographics, operative details, complications, and liver function test results were retrieved from the institutional database. HRQoL was assessed using the 36-Item Short Form Health Survey (SF-36) at 1, 3, 6, and 12 months postoperatively, prospectively administered during follow-up visits and retrospectively reviewed. Statistical analyses included the t test, Fisher exact test, Mann-Whitney U test, and repeated-measures ANOVA.
RESULTS
Baseline characteristics were similar between groups except for higher education levels among PLDH donors (P<0.001). PLDH group showed a trend toward shorter hospital stay (6.83 vs 8.44 days; P=0.055). Postoperative complications and liver function test results were similar. PLDH donors reported significantly higher HRQoL scores in physical function, role physical, general health, and social function domains (P<0.05), with favorable trends in other domains.
CONCLUSIONS
In this low-volume LDLT center, PLDH demonstrated perioperative safety comparable to CODH, while achieving superior recovery in multiple HRQoL domains and reduced transfusion requirements. These findings support PLDH as the preferred donor approach when expertise is available.

Keywords: Hepatectomy; Laparoscopy; Liver Transplantation; Quality of Life; Retrospective Studies; Surgery