title: Congestion of right liver graft in living donor liver transplantation.
abstract: 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.
authors.affiliation: Department of General Surgery, Asan Medical Center, Ulsan University, Songpa-Gu, Seoul, Korea.
authors.forename: S
authors.initials: S
authors.lastname: Lee
authors.forename: K
authors.initials: K
authors.lastname: Park
authors.forename: S
authors.initials: S
authors.lastname: Hwang
authors.forename: Y
authors.initials: Y
authors.lastname: Lee
authors.forename: D
authors.initials: D
authors.lastname: Choi
authors.forename: K
authors.initials: K
authors.lastname: Kim
authors.forename: K
authors.initials: K
authors.lastname: Koh
authors.forename: S
authors.initials: S
authors.lastname: Han
authors.forename: K
authors.initials: K
authors.lastname: Choi
authors.forename: K
authors.initials: K
authors.lastname: Hwang
authors.forename: M
authors.initials: M
authors.lastname: Makuuchi
authors.forename: Y
authors.initials: Y
authors.lastname: Sugawara
authors.forename: P
authors.initials: P
authors.lastname: Min
mesh_terms: 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