Sharing the middle hepatic vein between donor and recipient: left liver graft procurement preserving a large segment VIII branch in donor.
There are few reported techniques to minimize the congestion in the donor after left liver graft procuring. If a large tributary of the middle hepatic vein (MHV) draining segment VIII (V8) converges into the root of the MHV in a donor of left liver, this branch should be preserved on the donor side. The volume of congested area when the V8 was ligated was predicted preoperatively by computed tomography (CT) and examined intraoperatively by the clamp test. Postoperative regeneration of the donor liver was evaluated by CT volumetry. This technique was used in 3 cases. The regeneration rate after 3 months of the right paramedian sector was 27, 38, and 8%, and that of the right lateral sector was 31, 63, and 39% in each donor, respectively. No severe complications occurred in the donors. In conclusion, V8 preservation in donors who underwent left liver resection led to satisfactory regeneration both of the right paramedian and lateral sectors and can minimize congestion in remnant liver.
Kishi
Yoji
Y
Department of Surgery, Artificial Organ and Transplantation Division, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Sugawara
Yasuhiko
Y
Akamatsu
Nobuhisa
N
Kaneko
Junichi
J
Matsui
Yuichi
Y
Kokudo
Norihiro
N
Makuuchi
Masatoshi
M
D000293:Adolescent; D000328:Adult; D016063:Blood Loss, Surgical; D004210:Dissection; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006503:Hepatic Veins / Q000601:surgery*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D008115:Liver Regeneration; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D014057:Tomography, X-Ray Computed