Our experience has shown the feasibility of controlling rejection and other complications in adult ABO-incompatible liver transplantation under intraportal infusion therapy.

In living donor liver transplantation, the safety of the donor operation is the highest priority. The introduction of the right lobe graft was late because of concerns about donor safety. We investigated donor liver regeneration by the types of resected segments as well as recipients to assess that appropriate regeneration was occurring. Eighty-seven donors were classified into 3 groups: left lateral section donors, left lobe donors, and right lobe donors. Forty-seven adult recipients were classified as either left or right lobe grafted recipients. Volumetry was retrospectively performed at 1 week, 1, 2, 3, and 6 months, and 1 year after the operation. In the right lobe donor group, the remnant liver volume was 45.4%, and it rapidly increased to 68.9% at 1 month and 89.8% at 6 months. At 6 months, the regeneration ratios were almost the same in all donor groups. The recipient liver volume increased rapidly until 2 months, exceeding the standard liver volume, and then gradually decreased to 90% of the standard liver volume. Livers of the right lobe donor group regenerated fastest in the donor groups, and the recipient liver regenerated faster than the donor liver. Analyzing liver regeneration many times with a large number of donors enabled us to understand the normal liver regeneration pattern. Although the donor livers did not reach their initial volume, the donors showed normal liver function at 1 year. The donors have returned to their normal daily activities. Donor hepatectomy, even right hepatectomy, can be safely performed with accurate preoperative volumetry and careful decision-making concerning graft-type selection. Liver Transpl 14: [1718][1719][1720][1721][1722][1723][1724] 2008 Living donor liver transplantation (LDLT) plays an important role because of cultural attitudes and the scarcity of cadaveric donations in Japan.1 LDLT involves an ethical problem: because the donor operation is performed on a healthy person, donor safety is the highest priority and requires special attention. LDLT was a treatment first for infants, then for children, and finally for adults. Although a left lobe graft provides enough volume for pediatric recipients, some adult recipients require a right lobe graft. There is little question about donor safety, on the basis of remnant liver volume requirements alone, if only a left lateral section and left lobe graft are procured. It is in the use of a right lobe that issues of donor safety come into play. Several authors have studied donor safety, especially with respect to surgical complications and clinical courses.2,3 Donor safety from various standpoints should be studied further in order to gain insight into the postoperative recovery pattern of a healthy person and to prevent complications.Although the human liver can tolerate more than 70% hepatectomy, 4 unfortunately some living donors have died of excessive loss of the liver.5-7 Precise evaluations of donor liver volume are important in order to prevent unexpected hepatic insufficiency and to evaluate normal liver rege...

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The recent popularity of prenatal magnetic resonance (MR) imaging has been associated with the development of ultrafast MR imaging techniques such as the single-shot fast spin-echo sequence. However, the majority of previous reports have concerned the fetal central nervous system (CNS) and chest disorders. MR imaging can demonstrate non-CNS fetal anatomy and pathologic conditions clearly. With its excellent tissue contrast, MR imaging provides information that supplements that provided by ultrasonography (US), especially in cases of neck, chest, and gastrointestinal lesions. Because of its large field of view, MR imaging allows evaluation of the relationship between a large lesion and adjacent structures. MR imaging should be considered if the diagnosis of a suspected non-CNS lesion is unclear at fetal US. MR imaging plays an important complementary role to US in cases of non-CNS fetal lesions and will be further accepted for fetal imaging in the future.

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