title: Middle hepatic vein tributary reconstruction could not act as a complete substitute for an entirely preserved middle hepatic vein.
abstract: OBJECTIVE
  The necessity of the middle hepatic vein for living donor liver transplantation using right lobe graft is still controversial.
  
  
  METHODS
  We reviewed 7 long-term surviving right-lobe recipients in whom middle hepatic vein tributaries were not reconstructed (group A, n=4) or were reconstructed (group B, n=3). Volume regeneration of the right paramedian (segments V+VIII) and right lateral (segments VI+VII) sectors was assessed by computed tomography at 3, 6, 9, and 12 postoperative months. The right paramedian sector was further subdivided into the ventral portion in relation to the anterior branch of the right portal vein and dorsal portion.
  
  
  RESULTS
  The volume regeneration ratio was significantly lower in group A than in group B persistently after 6 postoperative months in regard to the right paramedian sector, the dorsal portion, and especially the ventral portion (0.64 +/- 0.19 vs. 1.22 +/- 0.17, p=0.034, 12 postoperative months). However, volume regeneration was impaired in the ventral portion as compared to other areas in group B.
  
  
  CONCLUSIONS
  In conclusion, middle hepatic vein tributary reconstruction improves the volume regeneration of the right paramedian sector in right lobe living donor liver transplantation However, it could not act as a complete substitute for an entirely preserved middle hepatic vein.
authors.affiliation: Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine Yokohama, Japan. dmorioka@hotmail.com
authors.forename: Daisuke
authors.initials: D
authors.lastname: Morioka
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Sekido
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Matsuo
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Takeda
authors.forename: Mitsutaka
authors.initials: M
authors.lastname: Sugita
authors.forename: Toru
authors.initials: T
authors.lastname: Kubota
authors.forename: Kuniya
authors.initials: K
authors.lastname: Tanaka
authors.forename: Itaru
authors.initials: I
authors.lastname: Endo
authors.forename: Shinji
authors.initials: S
authors.lastname: Togo
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shimada
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006503:Hepatic Veins / Q000601:surgery*; D006801:Humans; D008107:Liver Diseases / Q000401:mortality / Q000601:surgery*; D008115:Liver Regeneration; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome