Chinese guidelines for minimally invasive surgery in liver transplant recipients (2025)

Abstract

Liver transplantation is an effective treatment for end-stage liver disease. Liver transplantation is technically complex and associated with significant trauma. In recent years, minimally invasive surgical techniques, such as laparoscopy and robotic surgery, have rapidly developed and been widely applied in various surgical fields. Minimally invasive surgery offers advantages including reduced trauma, less bleeding, and faster postoperative recovery, and has become a mainstream trend in surgical development. In the field of liver transplantation, laparoscopic and robotic donor hepatectomy techniques for living donor liver transplantation have made significant progress. However, due to difficulties in exposing the anastomotic sites of the donor liver and challenges in vascular anastomosis, the application of minimally invasive techniques in donor liver implantation has progressed relatively slowly. With advancements in laparoscopic and robotic surgical techniques and related instruments, laparoscopic donor liver implantation has gradually become feasible. Currently, multiple liver transplant centers worldwide have begun to progressively perform laparoscopic or robot-assisted liver transplantation in recipients, demonstrating potential advantages in reducing surgical trauma and accelerating postoperative recovery. However, there is currently a lack of guidelines or consensus on the application of minimally invasive surgery in liver transplant recipients. Therefore, Branch of Organ Transplantation of Chinese Medical Association, Surgery Group of Chinese Society of Surgery of Chinese Medical Association, and Branch of Organ Transplant Physicians of Chinese Medical Doctor Association invited experts in the field to discuss clinical issues. Combining published guidelines, consensus statements, and research advancements, they formulated the "Technical guidelines for laparoscopic-assisted Liver transplantation in recipients," aiming to provide reasonable guidance and references for clinical practitioners in the field of liver transplantation.