Vein reconstruction in modified right liver graft for living donor liver transplantation.
OBJECTIVE
To report the authors' experience with hepatic vein reconstruction and plasty in living donor liver transplantation for adult patients.


BACKGROUND
A right liver graft without the middle hepatic vein (MHV) trunk (modified right liver graft) can cause severe congestion of the right paramedian sector. However, the need for MHV reconstruction has not been fully recognized.


METHODS
From June 2000 to December 2001, 30 adult patients received a modified right liver graft. Major MHV tributaries were preserved and reconstructed under the authors' criteria. Plasty of recipient hepatic veins for a wide outflow orifice was performed when necessitated. The regeneration of paramedian and lateral sectors of the grafts was examined by computed tomography 1 and 3 months after the operation.


RESULTS
MHV tributaries were reconstructed in 18 grafts. Plasty of recipient hepatic veins was performed in 15 patients. All patients survived the operation. The regeneration of paramedian and lateral sectors was equivalent.


CONCLUSIONS
A modified right liver graft can provide satisfactory surgical results if hepatic vein reconstruction and plasty are performed using the present techniques.
Sugawara
Yasuhiko
Y
Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. yasusuga-tky@umin.ac.jp
Makuuchi
Masatoshi
M
Sano
Keiji
K
Imamura
Hiroshi
H
Kaneko
Junichi
J
Ohkubo
Takao
T
Matsui
Yuichi
Y
Kokudo
Norihiro
N
D000293:Adolescent; D000328:Adult; D005260:Female; D006503:Hepatic Veins / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008099:Liver / Q000098:blood supply; D008107:Liver Diseases / Q000601:surgery; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D018608:Ultrasonography, Doppler; D014654:Vascular Patency; D014656:Vascular Surgical Procedures / Q000379:methods*; D014689:Venous Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery