中华医学杂志（英文版）2007，Vol.120Issue(11)：947-951,5.
Hepatic venous outflow reconstruction in adult right lobe living donor liver transplantation without middle hepatic vein
Hepatic venous outflow reconstruction in adult right lobe living donor liver transplantation without middle hepatic vein
WU Hong 1LU Qiang 1CHEN Zhe-yu 1MA Yu-kui 1LI Jin 1YANG Jia-yin 1YAN Lü-nan 1LI Bo 1ZENG Yong 1WEN Tian-fu 1ZHAO Ji-chun 1WANG Wen-tao 1XU Ming-qing1
作者信息
- 1. Center of Liver Transplantation, West China Hospital, Sichuan University, Chengdu 610041, China
- 折叠
摘要
Abstract
Background It is difficult and challenging to reconstruct hepatic venous outflow in adult right lobe living donor liver transplantation (LDLT) without the middle hepatic vein (MHV). Excessive perfusion of the portal vein and venous outflow obstruction will lead to acute congestion of the graft, ultimately resulting in primary nonfunction. Although various reconstruction patterns have been explored in many countries, there is currently no clear consensus. In this study we describe a technique to prevent "chocking" of the graft at the outflow anastomosis with the inferior vena cava (IVC) in LDLT using right lobe graft without the MHV.Methods A retrospective analysis was conducted on clinical data from 55 recipients undergoing LDLT using right lobe grafts without the MHV or reconstruction of hepatic venous outflow. The donor's right hepatic vein (RHV) was anastomosed with a triangular opening of the recipient IVC; the inferior right hepatic vein (IRHV), if large enough, was anastomosed directly to the IVC. The great saphenous vein (GSV) was used for reconstruction of significant MHV tributaries.Results No deaths occurred in any of the donors. Of the 55 recipients, complications occurred in 6, including hepaticvein stricture (1 case), small-for-size syndrome (1), hepatic artery thrombosis (1), intestinal bleeding (1), bile leakage (1),left subphrenic abscess and pulmonary infection (1). A total of three patients died, one from small-for-size syndrome and two from multiple system organ failure.Conclusions The multiple-opening vertical anastomosis was reconstructed with hepatic vein outflow. This technique alleviates surgical risk of living donors, ensures excellent venous drainage, and prevents vascular thromboses and primary nonfunction.关键词
living donor liver transplantation/right lobe graft/living donorsKey words
living donor liver transplantation/right lobe graft/living donors分类
医药卫生引用本文复制引用
WU Hong,LU Qiang,CHEN Zhe-yu,MA Yu-kui,LI Jin,YANG Jia-yin,YAN Lü-nan,LI Bo,ZENG Yong,WEN Tian-fu,ZHAO Ji-chun,WANG Wen-tao,XU Ming-qing..Hepatic venous outflow reconstruction in adult right lobe living donor liver transplantation without middle hepatic vein[J].中华医学杂志（英文版）,2007,120(11):947-951,5.
