[Modifications of surgical technique in adult-to-adult living donor liver transplantation]

Full Abstract

OBJECTIVE:
To report the authors' experience with adult-to-adult living donor liver transplantation using right lobe liver grafts performed by a modified technique.

METHODS:
From March to June 2005, 13 patients underwent living donor liver transplantation using right lobe grafts. Among these, one patient received two left lobes from his two elder sisters, one received a right lobe from his mother and a left lobe from a cadaveric donor. All patient underwent a modification designed to improve the reconstruction of right hepatic vein, the reconstruction the tributaries of the middle hepatic vein by interpositioning a vein grafts, and the anastomosis of the hepatic arteries and bile ducts.

RESULTS:
There were no severe complications and deaths found in donors. Four complications occurred in recipients including hepatic artery thrombosis (n = 1), bile leakage (n = 1), left subphrenic abscess (n = 1) and pulmonary infection (n = 1). The patient with pulmonary infection died of multiple organ failure (MOF). All patients underwent direct anastomosis of right hepatic vein and inferior vena cava (IVC), 5 cases plus the reconstructions of right inferior hepatic vein, and the other 5 cases plus the reconstruction of the tributaries of the middle hepatic vein by interpositioning a vein graft to provide sufficient venous outflow. The graft and recipient weight ratio (GRWR) were between 0.72% and 1.24%, among these, 9 cases < 1.0% and 2 cases < 0.8%, and there was no "small-for-size syndrome" occurred.

CONCLUSIONS:
With modifications of surgical technique, especially the reconstruction of hepatic vein to provide sufficient venous outflow, living donor liver transplantation in adults using right lobe liver grafts can become a relatively safe procedure and prevent the "small-for-size syndrome".

Learn Faster Today Improve your study skills

Author information

Author/s: Yan, Lü-nan (LN); Li, Bo (B); Zeng, Yong (Y); Wen, Tian-fu (TF); Zhao, Ji-chun (JC); Wang, Wen-tao (WT); Yang, Jia-yin (JY); Xu, Ming-qing (MQ); Ma, Yu-kui (YK); Chen, Zhe-yu (ZY); Liu, Jiang-wen (JW); Wu, Hong (H);

Affiliation: Liver Transplantation Division, Department of Surgery, West China Hospital, Sichuan University, Chengdu 610041, China. yanlunan688(-atsign-)163.com

Journal and publication information

Publication Type: English Abstract; Journal Article

Journal: Zhonghua wai ke za zhi [Chinese journal of surgery] (Zhonghua Wai Ke Za Zhi), published in China. (Language: chi)

Reference: 2006-Jun; vol 44 (issue 11) : pp 737-41

Dates: Created 2006/07/13; Completed 2007/04/26;

PMID: 16836919, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

External Links for this article (including full text providers, if available):

Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.

This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.

MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult
Aged
Female
Follow-Up Studies
Humans
Liver Transplantation - methods

Liver Transplantation - methods
Living Donors
Male
Middle Aged
Postoperative Complications - prevention & control
Transplantation, Homologous

These are the highest related articles currently in the database:

See 100+ related articles.