Donor/recipient algorithm for management of the middle hepatic vein in right graft live donor liver transplantation

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RESEARCH PRODUCT

Donor/recipient algorithm for management of the middle hepatic vein in right graft live donor liver transplantation

Andrea Schenk Georgios C. Sotiropoulos George Sgourakis Arnold Radtke Ernesto P. Molmenti Fuat H. Saner M. Malagó Hauke Lang Susanne Beckebaum C. E. Broelsch Tobias Schroeder Silvio Nadalin

subject

Graft Rejection Male medicine.medical_specialty Tissue and Organ Procurement Live donor medicine.medical_treatment Hepatic Veins Liver transplantation liver Body weight Risk Assessment Preoperative care Computed tomographic Cohort Studies Imaging Three-Dimensional Postoperative Complications Preoperative Care Living Donors medicine Graft selection Hepatectomy Humans Prospective Studies Analysis of Variance Small for size syndrome business.industry Patient Selection Graft Survival General Medicine Liver Transplantation Surgery Treatment Outcome surgical procedures operative Mathematik Female Surgery Hepatectomy Tomography X-Ray Computed business Algorithm Algorithms Follow-Up Studies Liver Circulation

description

Abstract Background The aim of this study was to delineate an algorithm for donor and recipient criteria and middle hepatic vein (MHV) management in right-graft live-donor liver transplantation (LDLT) on the basis of computerized 3-dimensional computed tomographic image analysis. Methods Data on 94 consecutive right-graft LDLTs were prospectively collected. Graft and remnant data for the first 23 cases were retrospectively evaluated by means of 3-dimensional computed tomographic reconstructions, and on the basis of that preliminary series, a graft selection algorithm using 3 parameters—hepatic vein dominance classification, graft and remnant graft volume/body weight ratios, and congestion volumes—was created. It was subsequently applied to the next 71 right-graft LDLTs. Results Fifty-nine right grafts contained the MHV. Four of the 12 grafts with no MHVs required MHV reconstructions. In 18 cases, small liver grafts were used. The postoperative function of liver grafts and remnants with versus without MHVs was not statistically different. Conclusions The proposed algorithm favored the inclusion of the MHV with the right grafts. It also allowed for the procurement of grafts that were potentially small for size without compromising donor or recipient safety.

year	journal	country	edition	language
2010-01-01	The American Journal of Surgery

https://doi.org/10.1016/j.amjsurg.2009.03.024