0000000000385333
AUTHOR
Massimo Malagó
Formation of Venous Collaterals and Regeneration in the Donor Remnant Liver: Volumetric Analysis and Three-Dimensional Visualization
Abstract Purpose We sought was to quantify and visualize the regeneration of the remnant liver after living donor liver transplantation using computed tomographic (CT) data. Methods For the evaluation of preoperative and follow-up data, we developed a software assistant that was able to compute the volume growth of the remnant liver and liver territories as well as visualize the individual growth of hepatic vessels over time. The software was applied to CT data of 20 donors who underwent right hepatectomy including the middle hepatic vein with at least 3 follow-up examinations in the first year after transplantation. Results After donation of a right lobe graft, the remnant liver regenerate…
“Anatomical” versus “Territorial” Belonging of the Middle Hepatic Vein: Virtual Imaging and Clinical Repercussions
Background Venous drainage patterns are of vital importance in live donor liver transplantation. The purpose of this study was to delineate “anatomical-topographical” and “territorial-physiologic” patterns of the middle hepatic vein (MHV) in a 3-D liver model as determined by the Pringle line and its drainage volume of the right and left hemilivers. Methods One hundred thirty-seven consecutive live donor candidates were evaluated by 3-D CT reconstructions and virtual hepatectomies. Based on right (R) and left (L), anatomical (A) and territorial (T) belonging patterns of the MHV, each individual was assigned to one of four possible types: type I:AR–TR; type II:AL–TL; type III:AR–TL; type IV:…
Liver failure after partial hepatic resection: definition, pathophysiology, risk factors and treatment
Liver failure is a dreaded and often fatal complication that sometimes follows a partial hepatic resection. This article reviews the definition, incidence, pathogenesis, risk factors, risk assessment, prevention, clinical features and treatment of post-resectional liver failure (PLF). A systematic, computerized search was performed using key words related to 'partial hepatic resection' and 'liver failure' to review most relevant literature about PLF published in the last 20 years. The reported incidence of PLF ranges between 0.7 and 9.1%. An inadequate quantity or quality of residual liver mass are key events in its pathogenesis. Major risk factors are the presence of comorbid conditions, p…
How to Handle Arterial Conduits in Liver Transplantation? Evidence From the First Multicenter Risk Analysis
OBJECTIVE: The aims of the present study were to identify independent risk factors for conduit occlusion, compare outcomes of different AC placement sites, and investigate whether postoperative platelet antiaggregation is protective. BACKGROUND: Arterial conduits (AC) in liver transplantation (LT) offer an effective rescue option when regular arterial graft revascularization is not feasible. However, the role of the conduit placement site and postoperative antiaggregation is insufficiently answered in the literature. STUDY DESIGN: This is an international, multicenter cohort study of adult deceased donor LT requiring AC. The study included 14 LT centers and covered the period from January 2…