Safety of donor right hepatectomy for adult-to-adult living donor liver transplantation.
The purpose of this study was to ascertain the usefulness of preoperative evaluations of donors by computed tomography (CT) volumetry and CT cholangiography for prevention of unexpected liver failure and biliary complications after donor right hepatectomy for adult-to-adult living donor liver transplantation. Fifty-two donors who underwent right hepatectomy without the middle hepatic vein were enrolled in this study. The values of graft weight (GW) were significantly correlated with those of estimated graft volume (GV; P < 0.0001). GW was predicted by the following formula: GW = 155.25 + 0.658 x GV; r(2) = 0.489. CT cholangiography revealed anatomical variants of biliary structure in one-third of the donors and also clearly showed one or two small biliary branches from the caudate lobe to the right hepatic ducts or the confluence in 58% of the donors. Biliary leakage, which was treated by conservative therapy, occurred in only one donor (1.9%). No donors received homologous blood transfusion. Hyperbilirubinemia (serum total bilirubin >5 mg/dl) occurred in 5.8% of the donors during their early postoperative periods. Precise evaluations of liver remnant volume by CT volumetry and biliary variation by CT cholangiography are essential for performing safe donor hepatectomy, preventing hepatic insufficiency and minimizing the risk of biliary tract complications.
Itamoto
Toshiyuki
T
Department of Surgery, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Science, Hiroshima University, Hiroshima, Japan. titamoto@hiroshima-u.ac.jp
Emoto
Kentaro
K
Mitsuta
Hiroshi
H
Fukuda
Saburo
S
Ohdan
Hideki
H
Tashiro
Hirotaka
H
Asahara
Toshimasa
T
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001659:Biliary Tract / Q000378:metabolism; D001663:Bilirubin; D001803:Blood Transfusion; D002758:Cholangiography; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006503:Hepatic Veins / Q000473:pathology; D006801:Humans; D008099:Liver / Q000378:metabolism; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D011517:Prothrombin Time; D012044:Regression Analysis; D012449:Safety; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods
D001663:Bilirubin