Safe donor hepatectomy for living related liver transplantation

Abstract

Minimizing the risk of donor hepatectomy while preserving graft viability is an important concern in living related liver transplantation. This report describes clinical outcomes for living donor hepatectomy with reference to the type of hepatectomy. Donor hepatectomy was performed in 130 consecutive living donors. They were divided into three groups: left lateral or extended left lateral segmentectomy (group S; n ‫؍‬ 50), left hepatectomy with or without caudate lobe or right lateral resection (group L; n ‫؍‬ 64), and right hepatectomy (group R; n ‫؍‬ 16). Intraoperative and postoperative data were examined and compared among the groups. No critical complications were observed in any group. However, there were differences in donor age, surgical and ischemia times, volume of blood loss, graft weight, and aspartate aminotransferase level elevation among the groups. Livers showed a substantial increase in volume, tending to the standard liver volume 1 month after surgery. Regardless of the extent of donor hepatectomy, serious complications did not occur after surgery. Surgical risk for a living donor is minimal if the operation is performed by experienced surgeons using present procedures. (Liver Transpl 2002;8:58-62.)

Reducing Bile Leak Following Segmental Liver Transplantation: Understanding Biliary Anatomy of the Caudate Lobe

“…In case segment I is not retained with the left liver, the bile leak occurs from divided Spiegel's lobe ducts on the LHD side and the leak will be a high-volume leak as it is directly from the left duct system. This may explain a lower incidence of bile leak in left liver donors with retained segment I reported by Sugawara et al (10).…”

Living donor liver transplantation for hepatitis B cirrhosis

“…Donor selection criteria were described previously. 9 Briefly, computed tomography was used to measure graft volume. An estimated graft volume to recipient standard liver volume 10 ratio of 40% was the lower limit for the graft.…”

Outflow reconstruction in extended right liver grafts from living donors

“…6 In a basin, the graft was flushed with 1 L of University of Wisconsin solution through a cannula inserted into the right portal vein. If the orifices of the MHV and right hepatic vein (RHV) were located close to each other, we performed a septoplasty.…”