title: Subcapsular hematoma after right-lobe living-donor liver transplantation.
abstract: Because right-lobe living-donor liver transplantation was introduced in adult-to-adult liver transplantation to mitigate the problems of small-for-size grafts, some technical controversies have been reported. This report describes a case of graft subcapsular hematoma due to parenchymal injury. A 53-year-old woman underwent a right-lobe living-donor liver transplantation for acute-on-chronic liver failure due to primary biliary cirrhosis. A huge subcapsular hematoma was discovered by routine Doppler echogram examination on the first posttransplantation day. Relaparotomy findings revealed that rotation of the graft for the hemostasis procedure during the transplant operation had induced a compression injury to the graft by the xiphoid process. It was speculated that a small laceration in the graft parenchyma led to the major subcapsular hematoma. This experience suggests that the graft liver must be handled with special care to prevent potential mechanical injury.
authors.affiliation: Organ Transplant Unit, Kyoto University Hospital, Kyoto, Japan.
authors.forename: Mureo
authors.initials: M
authors.lastname: Kasahara
authors.forename: Koichi
authors.initials: K
authors.lastname: Kozaki
authors.forename: Toru
authors.initials: T
authors.lastname: Yoshida
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Kohei
authors.initials: K
authors.lastname: Ogawa
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ogura
authors.forename: Koichi
authors.initials: K
authors.lastname: Tanaka
mesh_terms: D015150:Echocardiography, Doppler; D005260:Female; D006406:Hematoma / Q000000981:diagnostic imaging / Q000209:etiology*; D006488:Hemostasis, Surgical; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology*; D022125:Lacerations / Q000150:complications; D008099:Liver / Q000293:injuries; D008107:Liver Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008875:Middle Aged