Venous Outflow Reconstruction in Adult Living Donor Liver Transplant: Outcome of a Policy for Right Lobe Grafts without the Middle Hepatic VeinReport as inadecuate




Venous Outflow Reconstruction in Adult Living Donor Liver Transplant: Outcome of a Policy for Right Lobe Grafts without the Middle Hepatic Vein - Download this document for free, or read online. Document in PDF available to download.

HPB SurgeryVolume 2013 2013, Article ID 280857, 11 pages

Clinical Study

Liver Transplant Department, National Liver Institute, Menoufiya University, Shebeen El-Koum, Egypt

University Department of Surgery and Liver Transplant Unit, Royal Free Hospital Trust and Royal Free and University College School of Medicine, Hampstead Campus, Pond Street, London NW3 2QG, UK

Received 10 July 2013; Revised 27 October 2013; Accepted 29 October 2013

Academic Editor: Shu-Sen Zheng

Copyright © 2013 Mohamed Ghazaly et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. The difficulty and challenge of recovering a right lobe graft without MHV drainage is reconstructing the outflow tract of the hepatic veins. With the inclusion or the reconstruction of the MHV, early graft function is satisfactory. The inclusion of the MHV or not in the donor’s right lobectomy should be based on sound criteria to provide adequate functional liver mass for recipient, while keeping risk to donor to the minimum. Objective. Reviewing the results of a policy for right lobe grafts transplant without MHV and analyzing methods of venous reconstruction related to outcome. Materials and Methods. We have two groups Group A with more than one HV anast. and Group B single HV anast. . Both groups were compared regarding indications for reconstruction, complications, and operative details and outcomes, besides describing different modalities used for venous reconstruction. Results. Significant increase in operative details time in Group A. When comparison came to complications and outcomes in terms of laboratory findings and overall hospital stay, there were no significant differences. Three-month and one-year survival were better in Group A. Conclusion. Adult LDLT is safely achieved with better outcome to recipients and donors by recovering the right lobe without MHV, provided that significant MHV tributaries segments V, VIII more than 5 mm are reconstructed, and any accessory considerable inferior right hepatic veins IRHVs or superficial RHVs are anastomosed.





Author: Mohamed Ghazaly, Mohamad T. Badawy, Hosam El-Din Soliman, Magdy El-Gendy, Tarek Ibrahim, and Brian R. Davidson

Source: https://www.hindawi.com/



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