Caudal middle hepatic vein trunk preserved right lobe graft in living donor liver transplantation

Kwangho Yang; Youngmok Park; Kimyung Moon; Jeho Ryu; Chongwoo Chu

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자료유형: 학술저널

저자정보: Kwangho Yang (Pusan National University School of Medicine) Youngmok Park (Pusan National University School of Medicine) Kimyung Moon (Pusan National University School of Medicine) Jeho Ryu (Pusan National University School of Medicine) Chongwoo Chu (Pusan National University School of Medicine)

저널정보: 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.87 No.4

발행연도: 2014.9

수록면: 185 - 191 (7page)

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Purpose: Multiple segment 5 vein (V5) anastomoses are common and inevitable in living donor liver transplantation (LDLT) using modified right lobe (MRL) graft. Sacrifice of segment 4a vein (V4a) can simplify bench work and avoid graft congestion. But it could be harmful to some donors in previous simulation studies. This study aimed to evaluate donor safety in LDLT using caudal middle hepatic vein trunk preserved right lobe (CMPRL) graft.
Methods: LDLT using MRL grafts were performed on 33 patients (group A) and LDLT using CMPRL grafts were performed on 37 patients (group B). Group B was classified into 2 subgroups by venous drainage pattern of segment 4: V4a dominant drainage group (group B1) and the other group (group B2). Parameters compared between group A donors and group B donors included operation time, bench work time, number and diameter of V5, remnant liver volume and postoperative course. Those were also investigated in group B1 compared with group B2. And, we reviewed postoperative course of the recipients in groups A and B.
Results: Operation time and bench work time in group B were significantly shorter. There were no significant differences in most postoperative parameters between groups B1 and B2. As a result of recipient, V5 patency rates after LDLT were significantly higher in group B.
Conclusion: LDLT using CMPRL graft is a safe procedure for living donors. Donors with any type of V4 could be proper candidates for CMPRL graft if remnant liver volume is greater than 30% with minimal fatty change.

#Living donors #Liver transplantation #Hepatic vein trunk preservation #Hepatectomy

참고문헌 (12)

참고문헌 신청

Chen CL. / 2003 / Living-donor liver transplantation: 12 years of experience in Asia / Transplantation 75(3 Suppl):S6~S11

Maetani Y. / 2003 / Factors influencing liver regeneration following livingdonor liver transplantation of the right hepatic lobe / Transplantation 75:97~102

Lee S. / 2001 / Congestion of right liver graft in living donor liver transplantation / Transplantation 71:812~814

Inomata Y. / 2000 / Right lobe graft in living donor liver transplantation / Transplantation 69:258~264

Sugawara Y. / 2003 / Vein reconstruction in modified right liver graft for living donor liver transplantation / Ann Surg 237:180~185