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- Title
The need for inclusion of the middle hepatic vein in right lobe graft in adult-to-adult live donor liver transplantation (LDLT).
- Authors
Fan, S.T.; Lo, C.M.; Liu, C.L.; Wong, J.
- Abstract
Aims: The necessity to include the middle hepatic vein (MHV) in a right lobe graft in adult-to-adult LDLT is controversial. In this study, we evaluated the outcome of patients with occlusion of the MHV at the time of portal vein reperfusion of the grafts to determine whether MHV inclusion is necessary in right lobe LDLT. Methods: From 1996 to 2002, 100 right lobe LDLT were performed. All right lobe grafts except one contained the MHV. The first recipient did not have the MHV reconstructed before reperfusion. In 7 other recipients, the MHV anastomosis was demonstrated to be completely occluded by Doppler ultrasonography. The occlusion was due to technical errors in adjusting the required length and orientation of the recipients' MHV. Thus 9 recipients did not have a patent MHV at the time of reperfusion by the portal vein. Results: There was no significant difference between recipients with (n = 9) and without (n = 91) occluded MHV in terms of preoperative ICU status, the aetiology of hepatic failure and graft weight/body weight ratio. On reperfusion, graft congestion and dusky right anterior sector were obvious in the 9 recipients without a patent MHV. The postoperative hepatic and renal function of these 9 recipients was worse than those with a patent MHV. The hospital mortality rate was also higher in those with an occluded MHV (3/9 vs. 5/91, P = 0·023). There was no donor mortality. Conclusion: Inclusion of the MHV in right lobe LDLT is essential for optimum graft function and recipient survival.
- Subjects
TRANSPLANTATION of organs, tissues, etc.; HEPATIC artery; HEALTH outcome assessment; ARTERIAL occlusions; REPERFUSION
- Publication
British Journal of Surgery, 2003, Vol 90, p23
- ISSN
0007-1323
- Publication type
Article