Results of transplantation of the hepatic right part from living familial donor
Objective. To estimate the immediate and late results in recipients while transplantation of the hepatic right part with median hepatic vein and without her.
Маterials and methods. Postoperative data about 86 patients, to whom the hepatic right half was transplanted in 2003 - 2018 yrs., with the objective to estimate the impact of presence of median hepatic vein in the transplant on the morbidity rate development, were analyzed. The patients were divided into two groups: Group I - the patients, to whom the hepatic right half was transplanted without median hepatic vein, while Group II - the patients, to whom the hepatic right half was transplanted with median hepatic vein.
Results. The investigation have revealed a higher rate of vascular complications in patients, to whom the hepatic right half was transplanted without median hepatic vein, comparing with the patients, to whom the hepatic right half was transplanted with median hepatic vein. The infection-septic complications have developed more frequently in patients, to whom the hepatic right part was transplanted without median hepatic vein. Nonspecific surgical morbidity developed in 10 (23.3%) patients of the Group I and in 8 (18.6%) patients of the Group II. The rate of development of the small hepatic transplant syndrome was higher in the Group I. Оne-year, two-year and five-year survival in the Group I have constituted 79, 72 and 69% accordingly, in the Group II - 83, 74 and 70% accordingly.
Conclusion. Our experience of performance of the hepatic right half transplantation witnesses, that presence of median hepatic vein in the transplant correlates with lowering of the postoperative morbidity rate, as well as with frequency of development the small hepatic transplant syndrome, postoperative mortality and the stationary stay duration.
Au KP, Chan SC, Chok KS, Chan AC, Wong TC, Sharr WW, et al. Durability of small-for-size living donor allografts. Liver Transpl.2015;21(11):1374-82. doi:10.1002/lt.24205.
Punch JD, Hayes DH, LaPorte FB, McBride V, Seely MS. Organ donation and utilization in the United States, 1996-2005. Am. J. Transplant. 2007;7(5-2):1327-38. doi:10.1111/j.1600-6143.2007.01779.x.
Urata K, Kawasaki S, Matsunami H, Hashikura Y, Ikegami T, Ishizone S, et al. Calculation of child and adult standard liver volume for liver transplantation. Hepatology. 1995;21(5):1317-21. doi.org/10.1016/0270-9139(95)90053-5.
Barr ML, Belghiti J, Villamil FG, Pomfret EA, Sutherland DS, Gruessner RW, et al. A report of the Vancouver Forum on the care of the live organ donor: lung, liver, pancreas, and intestine data and medical guidelines. Transplantation. 2006;81(10):1373-85. doi:10.1097/01.tp.0000216825.56841.cd.
Lee S, Park K, Hwang S, Lee Y, Kim K, Ahn C et al. Adult-to-Adult Living Donor Liver Transplantation at the Asan Medical Center, Korea. Asian J Surg. 2002;25(4):277-284. doi:10.1016/S1015-9584(09)60192-5.
Kiuchi, T, Oike, F, Yamamoto H, Small-for-size graft in liver transplantation. Nagoya J Med Sci. 2003;66(3-4):95-102. doi:10.18999/nagjms.66.3-4.95.
Troisi R, de Hemptinne B. Clinical relevance of adapting portal vein flow in living donor liver transplantation in adult patients. Liver Transpl. 2003;9(9):36-41. doi.org/10.1053/jlts.2003.50200.
Ben-Haim M, Emre S, Fishbein TM, Sheiner PA, Bodian CA, Kim-Schluger L, et al. Critical graft size in adult-to-adult living donor liver transplantation: impact of the recipient's disease. Liver Transpl. 2001;7(11):948-53. doi.org/10.1053/jlts.2001.29033.
Tanaka K, Ogura Y. "Small-for-size graft" and "small-for-size syndrome" in living donor liver transplantation. Yonsei Med J. 2004;45(6):1089-94. doi:10.3349/ymj.2004.45.6.1089.
Gyu Lee S, Min Park K, Hwang S, Hun Kim K, Nak Choi D, Hyung Joo S, et al. Modified right liver graft from a living donor to prevent congestion. Transplantation. 2002;74(1):54-9. doi: 10.1097/00007890-200207150-00010.
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