Lebendlebertransplantation

Tanaka, Kōichi; Kaihara, Satoshi

doi:10.1007/s00104-003-0744-1

Cited by 5 publications

(2 citation statements)

References 57 publications

(48 reference statements)

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“…A fusion of the results of vascular analysis and liver segmentation for the volume calculation of individual vascular territories was enabled by the use of mathematical models [ 4 ]. The term “territory” refers to the part of the liver that is supplied by a given portal vein branch or drained by a given hepatic vein branch and represents an individual functional unit [ 5 ].…”

Section: Methodsmentioning

confidence: 99%

Intrahepatic Vascular Anatomy in Rats and Mice—Variations and Surgical Implications

et al. 2015

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IntroductionThe intra-hepatic vascular anatomy in rodents, its variations and corresponding supplying and draining territories in respect to the lobar structure of the liver have not been described. We performed a detailed anatomical imaging study in rats and mice to allow for further refinement of experimental surgical approaches.MethodsLEWIS-Rats and C57Bl/6N-Mice were subjected to ex-vivo imaging using μCT. The image data were used for semi-automated segmentation to extract the hepatic vascular tree as prerequisite for 3D visualization. The underlying vascular anatomy was reconstructed, analysed and used for determining hepatic vascular territories.ResultsThe four major liver lobes have their own lobar portal supply and hepatic drainage territories. In contrast, the paracaval liver is supplied by various small branches from right and caudate portal veins and drains directly into the vena cava. Variations in hepatic vascular anatomy were observed in terms of branching pattern and distance of branches to each other. The portal vein anatomy is more variable than the hepatic vein anatomy. Surgically relevant variations were primarily observed in portal venous supply.ConclusionsFor the first time the key variations of intrahepatic vascular anatomy in mice and rats and their surgical implications were described. We showed that lobar borders of the liver do not always match vascular territorial borders. These findings are of importance for the design of new surgical procedures and for understanding eventual complications following hepatic surgery.

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Section: Methodsmentioning

confidence: 99%

Intrahepatic Vascular Anatomy in Rats and Mice—Variations and Surgical Implications

et al. 2015

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“…The demand for living donor liver transplantation (LDLT) is increasing because of the evolving transplant indication of hepatitis‐associated cirrhosis and HCC and a shortage of deceased organ donation 3, 4. Approximately 600 patients have received a LDLT in Asia, 500 in the United States, and 100 in Europe, annually, in recent years 5…”

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confidence: 99%

A novel 3D hepatectomy simulation based on liver circulation

et al. 2005

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Hepatectomy is a complicated operative procedure because of its anatomical complexity, vascular variability, and impaired hepatic function due to associated hepatitis or cirrhosis. Thus preoperative detailed topography and precise liver resection volume measurements should be obtained for a curative hepatectomy. The aim of this study was to assess the feasibility and accuracy of a novel three-dimensional (3D) virtual hepatectomy simulation software in patients who underwent liver resection or living donor liver transplantation. We developed the hepatectomy simulation software, which was programmed to analyze detailed 3D vascular structure and to predict liver resection volume and margins. In 72 patients receiving hepatectomy, the predicted liver resection volumes and margins revealed a significant correlation with the actual value with a mean difference of 9.3 mL (P < .0001) and 1.6 mm (P < .01), respectively. The drainage area by hepatic veins was quantified to achieve reconstruction of the corresponding venous branch. In conclusion, this hepatectomy simulation software reliably predicted an accurate liver resection volume, the cancer-free margin, and the drainage volume of hepatic vein branches. This software may promote curative hepatectomy and may be used for other interventional therapies in the treatment of liver disease. (HEPATOLOGY 2005;41:1297-1304

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Lebertransplantation mit Lebendspende

Settmacher

Bauschke

Malessa

et al. 2013

Chirurg

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More than 20 years ago living donor liver transplantation was introduced into clinical practice. Specifics of this method were developed initially for children and later on for adults particularly in regions where a liver transplantation program using deceased donors was not readily available. The most sensitive aspect of living donation, namely the danger to a healthy relative in order to perform the transplantation is immanent in the system and, thus, it is definitively a secondary option as compared to deceased organ donation. Following worldwide initial euphoria the numbers have markedly decreased in the western world since the start of the new millennium. In Asian countries in particular, much work has been done to optimize the procedure so that the donor safety and the outcome quality for the recipient have been impressively demonstrated in large patient populations. There is still a severe donor organ shortage and the option to allocate an optimal (partial) organ on an individual basis by living donation has given new impact to the discussion about a further rise in the profile of living donations here as well. The new version of the German transplantation legislation implemented in summer 2012 requires a number of conditions with respect to insurance for living donors. The current state and perspectives are presented here.

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Lebendlebertransplantation

Cited by 5 publications

References 57 publications

Intrahepatic Vascular Anatomy in Rats and Mice—Variations and Surgical Implications

Intrahepatic Vascular Anatomy in Rats and Mice—Variations and Surgical Implications

A novel 3D hepatectomy simulation based on liver circulation

Lebertransplantation mit Lebendspende

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