title: Analysis of postoperative liver function of donors in living-related liver transplantation: comparison of the type of donor hepatectomy.
abstract: BACKGROUND
  There is a potentially significant risk to the donor in living-related liver transplantation.
  
  
  METHODS
  We analyzed surgical risk and stress to 35 donors in living-related liver transplantation with special reference to the types of donor hepatectomy. Donor surgery was performed in one of three ways: (1) lateral segmentectomy without ligation of the middle hepatic vein (MHV) in the remnant liver (group 1, n=21); (2) lateral segmentectomy with ligation of MHV in the remnant liver (group 2, n=6); and (3) left lobectomy with MHV (group 3, n=8).
  
  
  RESULTS
  No critical complications were observed in any group. The postoperative enzyme levels in group 2 were significantly higher than those in groups 1 and 3 (P<0.01). Although blood loss was covered by autologous blood transfusion in the first six cases, no banked blood was transfused in any of the cases. Surgical duration was significantly longer and blood loss was significantly greater in group 3 than in group 1 (P<0.05). Follow-up computed tomography showed atrophic changes in segment IV in groups 1 and 2. No remarkable changes were seen in segments V or VIII in any of the three groups.
  
  
  CONCLUSIONS
  Regardless of the donor hepatectomy procedure, serious complications did nor occur after surgery. Although it should be noted that the type of donor hepatectomy affects postoperative donor liver function, left lateral segmentectomy with ligation of MHV in the remnant liver is a useful method for obtaining liver grafts from living-related donors who have unusual anatomic variations of the hepatic veins.
authors.affiliation: Department of Surgery III, Tokyo Women's Medical University, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Tojimbara
authors.forename: S
authors.initials: S
authors.lastname: Fuchinoue
authors.forename: I
authors.initials: I
authors.lastname: Nakajima
authors.forename: T
authors.initials: T
authors.lastname: Koike
authors.forename: M
authors.initials: M
authors.lastname: Abe
authors.forename: T
authors.initials: T
authors.lastname: Tsugita
authors.forename: T
authors.initials: T
authors.lastname: Otsubo
authors.forename: K
authors.initials: K
authors.lastname: Tanaka
authors.forename: T
authors.initials: T
authors.lastname: Agishi
authors.forename: K
authors.initials: K
authors.lastname: Takasaki
mesh_terms: D000328:Adult; D001284:Atrophy; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D007223:Infant; D008099:Liver / Q000000981:diagnostic imaging / Q000201:enzymology / Q000473:pathology / Q000503:physiopathology*; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D009929:Organ Size; D011183:Postoperative Complications; D011184:Postoperative Period; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome