TY - JOUR
T1 - Living-Donor Right Hepatectomy with or without Inclusion of Middle Hepatic Vein
T2 - Comparison of Morbidity and Outcome in 56 Patients
AU - Cattral, Mark S.
AU - Molinari, Michele
AU - Vollmer, Charles M.
AU - McGilvray, Ian
AU - Wei, Alice
AU - Walsh, Mark
AU - Adcock, Lesley
AU - Marks, Nikki
AU - Lilly, Les
AU - Girgrah, Nigel
AU - Levy, Gary
AU - Greig, Paul D.
AU - Grant, David R.
PY - 2004/5
Y1 - 2004/5
N2 - Venous congestion of segments V and VIII is observed frequently in living-donor right lobe liver transplants without middle hepatic vein (MHV) drainage, and can be a cause of graft dysfunction and failure. Inclusion of the MHV with the graft is controversial, however, because of the perceived potential for increased donor morbidity. We compared the outcome of living liver donors in whom the MHV was either left intact in the donor (group 1; n = 28) or was removed with the graft (group 2; n = 28). All prospective donors completed an extensive multidisciplinary evaluation to determine suitability for surgery and to ensure that the MHV could be removed safely without compromising venous outflow from the remaining liver. Patient demographics including age, weight, body-mass index, and liver volumetry as determined by computerized tomography were similar in both groups. Operative time in group 2 was significantly shorter than in group 1. There was no difference in estimated blood loss, transfusion requirements, peak serum liver tests, time interval from surgery to complete normalization of liver tests, complications, and length of hospitalization. We conclude that including the MHV with living-donor right lobe grafts can be performed safely in most donors.
AB - Venous congestion of segments V and VIII is observed frequently in living-donor right lobe liver transplants without middle hepatic vein (MHV) drainage, and can be a cause of graft dysfunction and failure. Inclusion of the MHV with the graft is controversial, however, because of the perceived potential for increased donor morbidity. We compared the outcome of living liver donors in whom the MHV was either left intact in the donor (group 1; n = 28) or was removed with the graft (group 2; n = 28). All prospective donors completed an extensive multidisciplinary evaluation to determine suitability for surgery and to ensure that the MHV could be removed safely without compromising venous outflow from the remaining liver. Patient demographics including age, weight, body-mass index, and liver volumetry as determined by computerized tomography were similar in both groups. Operative time in group 2 was significantly shorter than in group 1. There was no difference in estimated blood loss, transfusion requirements, peak serum liver tests, time interval from surgery to complete normalization of liver tests, complications, and length of hospitalization. We conclude that including the MHV with living-donor right lobe grafts can be performed safely in most donors.
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U2 - 10.1111/j.1600-6143.2004.00405.x
DO - 10.1111/j.1600-6143.2004.00405.x
M3 - Article
C2 - 15084170
AN - SCOPUS:2442528978
SN - 1600-6135
VL - 4
SP - 751
EP - 757
JO - American Journal of Transplantation
JF - American Journal of Transplantation
IS - 5
ER -