title: [Orthotopic liver transplantation from a living adult donor to an adult using the right hepatic lobe].
abstract: OBJECTIVE
  In children, living donor liver transplantation has been shown to be efficient in treating end-stage liver diseases when the left lateral segment is harvested. In adults, more liver mass is needed to provide adequate hepatic function. The aim of this study is to report 2 successful cases of living donor liver transplantation using a right hepatic lobe from adult.
  
  
  METHODS
  In 2 sons, the right hepatic lobe was harvested without the middle hepatic vein for transplantation in their fathers who were suffering from end-stage liver cirrhosis. Hepatectomy was done without vascular inflow occlusion after dissection of vascular and biliary structures, itself strictly restricted to the right side. In recipients, the graft was implanted orthotopically with preservation of the native inferior vena cava and after temporary porto-caval shunt.
  
  
  RESULTS
  The duration of donors procedures was 7 h and 11 h 45 min; intra-operative transfusions comprised of 700 mL from cell-saver in the first case, and 1300 mL plus 1 autologous red blood cell unit in the second case. Graft weights were 770 g and 1100 g. None of the donors experienced liver failure and both were able to leave the hospital 9 days after the operation. In recipients, initial graft function was excellent in the first case and correct in the second case, despite the necessity to redo intra-operatively the hepatic vein anastomosis secondary to a twisting. Patients were discharged 20 and 40 days respectively following transplantation.
  
  
  CONCLUSIONS
  Adult living donor liver transplantation using a right hepatic lobe is efficient and safe. This option could contribute to reducing the mortality of patients on the waiting list.
authors.affiliation: Unité de transplantation hépatique, hôpital Edouard-Herriot, Lyon, France.
authors.forename: O
authors.initials: O
authors.lastname: Boillot
authors.forename: M
authors.initials: M
authors.lastname: Dawahra
authors.forename: I
authors.initials: I
authors.lastname: Méchet
authors.forename: O
authors.initials: O
authors.lastname: Czyglik
authors.forename: P
authors.initials: P
authors.lastname: Bernard
authors.forename: Y
authors.initials: Y
authors.lastname: Le Derf
authors.forename: P
authors.initials: P
authors.lastname: Branche
authors.forename: I
authors.initials: I
authors.lastname: Bobineau
authors.forename: J
authors.initials: J
authors.lastname: Cabrera
authors.forename: P
authors.initials: P
authors.lastname: Sagnard
authors.forename: J
authors.initials: J
authors.lastname: Dumortier
authors.forename: L
authors.initials: L
authors.lastname: Henry
authors.forename: C
authors.initials: C
authors.lastname: Partensky
mesh_terms: D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical; D001804:Blood Transfusion, Autologous; D006498:Hepatectomy / Q000379:methods; D006499:Hepatic Artery / Q000601:surgery; D006801:Humans; D007430:Intraoperative Care; D007902:Length of Stay; D008103:Liver Cirrhosis / Q000601:surgery; D017093:Liver Failure / Q000601:surgery; D016031:Liver Transplantation / Q000379:methods* / Q000473:pathology; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012449:Safety; D013997:Time Factors; D014682:Vena Cava, Inferior / Q000601:surgery