Technical challenges of hepatic venous outflow reconstruction in right lobe adult living donor liver transplantation

被引:91
作者
Ghobrial, RM
Hsieh, CB
Lerner, S
Winters, S
Nissen, N
Dawson, S
Amersi, F
Chen, P
Farmer, D
Yersiz, H
Busuttil, RW
机构
[1] Univ Calif Los Angeles, Dumont Transplant Ctr, Dept Surg, Div Liver & Pancreas Transplantat, Los Angeles, CA 90095 USA
[2] Univ Calif Los Angeles, Sch Med, Dept Radiol, Los Angeles, CA 90024 USA
[3] Tri Serv Gen Hosp, Dept Surg, Natl Def Med Ctr, Taipei, Taiwan
关键词
D O I
10.1053/jlts.2001.24910
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
A right lobe graft that is drained by the right hepatic vein (RHV) is obtained by transecting the liver on the right side of the middle hepatic vein (MHV). On occasion, a small RHV that only drains a portion of the right lobe, with the predominant outflow achieved by the MHV, is encountered. If such variation is not recognized while performing right lobe liver transplantation and the RHV only is used for reconstruction, venous outflow obstruction with subsequent graft congestion and eventual graft failure will occur. Additionally, preservation of the main MHV and its branch drainage of the left lobe is crucial to avoid outflow blockage to the remaining segment 4 in the donor. We report 4 cases showing a variant type of small RHV and large MHV branch that drain not only segments 5 and 8, but also segments 6 and 7. These variations were simultaneously associated with a large-caliber inferior RHV that also required reconstruction. The methods used to diagnose such anatomic variations and the techniques for reconstruction in the donor and recipient are described.
引用
收藏
页码:551 / 555
页数:5
相关论文
共 16 条
[1]
Split liver transplantation [J].
Busuttil, RW ;
Goss, JA .
ANNALS OF SURGERY, 1999, 229 (03) :313-321
[2]
Hepatic vein reconstruction in 152 living-related donor liver transplantation patients [J].
Egawa, H ;
Inomata, Y ;
Uemoto, S ;
Asonuma, K ;
Kiuchi, T ;
Okajima, H ;
Yamaoka, Y ;
Tanaka, K .
SURGERY, 1997, 121 (03) :250-257
[3]
Safety of donors in live donor liver transplantation using right lobe grafts [J].
Fan, ST ;
Lo, CM ;
Liu, CL ;
Yong, BH ;
Chan, JKF ;
Ng, IOL .
ARCHIVES OF SURGERY, 2000, 135 (03) :336-340
[4]
Technical refinement in adult-to-adult living donor liver transplantation using right lobe graft [J].
Fan, ST ;
Lo, CM ;
Liu, CL .
ANNALS OF SURGERY, 2000, 231 (01) :126-131
[5]
GRAFT SIZE ASSESSMENT BY PREOPERATIVE COMPUTED-TOMOGRAPHY IN LIVING RELATED PARTIAL LIVER-TRANSPLANTATION [J].
HIGASHIYAMA, H ;
YAMAGUCHI, T ;
MORI, K ;
NAKANO, Y ;
YOKOYAMA, T ;
TAKEUCHI, T ;
YAMAMOTO, N ;
YAMAOKA, Y ;
TANAKA, K ;
KUMADA, K ;
OZAWA, K .
BRITISH JOURNAL OF SURGERY, 1993, 80 (04) :489-492
[6]
Left hemihepatectomy in living donors with a thick middle hepatic vein draining the caudal half of the right liver [J].
Hui, AM ;
Makuuchi, M ;
Takayama, T ;
Sano, K ;
Kubota, K ;
Harihara, Y ;
Matsunami, H .
TRANSPLANTATION, 2000, 69 (07) :1499-1501
[7]
Right lobe graft in living donor liver transplantation [J].
Inomata, Y ;
Uemoto, S ;
Asonuma, K ;
Egawa, H ;
Kiuchi, T ;
Fujita, S ;
Hayashi, M ;
Kawashima, M ;
Tanaka, K .
TRANSPLANTATION, 2000, 69 (02) :258-264
[8]
Living related liver transplantation in adults [J].
Kawasaki, S ;
Makuuchi, M ;
Matsunami, H ;
Hashikura, Y ;
Ikegami, T ;
Nakazawa, Y ;
Chisuwa, H ;
Terada, M ;
Miyagawa, S .
ANNALS OF SURGERY, 1998, 227 (02) :269-274
[9]
Minimum graft size for successful living donor liver transplantation [J].
Lo, CM ;
Fan, ST ;
Liu, CL ;
Chan, JK ;
Lam, BK ;
Lau, GK ;
Wei, WI ;
Wong, J .
TRANSPLANTATION, 1999, 68 (08) :1112-1116
[10]
Adult-to-adult living donor liver transplantation using extended right lobe grafts [J].
Lo, CM ;
Fan, ST ;
Liu, CL ;
Wei, WI ;
Lo, RJW ;
Lai, CL ;
Chan, JKF ;
Ng, IOL ;
Fung, A ;
Wong, J .
ANNALS OF SURGERY, 1997, 226 (03) :261-269