Congestion of right liver graft in living donor liver transplantation.
BACKGROUND
Left liver graft from a small donor will not meet the metabolic demands of a larger adult recipient. One solution to this problem is to use a right liver graft without a middle hepatic vein (MHV). However, the need for drainage from the MHV tributaries has not yet been described.


METHODS
Five right liver grafts without a MHV were transplanted in patients including two hepatitis B virus-cirrhosis, two fulminant hepatic failure and one secondary biliary cirrhosis. The graft weight ranged from 650 to 1,000 g, corresponding to 48 to 83% of the standard liver volume of the recipients.


RESULTS
Two of five recipients were complicated with severe congestion of the right median sector immediately after reperfusion, followed by prolonged massive ascites and severe liver dysfunction. One of the patients died of sepsis with progressive hepatic dysfunction 20 days after the operation.


CONCLUSIONS
Preservation and reconstruction of the MHV tributaries is recommended to prevent congestion of the right liver graft without MHV.
Lee
S
S
Department of General Surgery, Asan Medical Center, Ulsan University, Songpa-Gu, Seoul, Korea.
Park
K
K
Hwang
S
S
Lee
Y
Y
Choi
D
D
Kim
K
K
Koh
K
K
Han
S
S
Choi
K
K
Hwang
K
K
Makuuchi
M
M
Sugawara
Y
Y
Min
P
P
D001835:Body Weight; D006801:Humans; D008099:Liver / Q000033:anatomy & histology; D017093:Liver Failure / Q000209:etiology*; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D009929:Organ Size