[Adult-to-adult living donor liver transplantation].
OBJECTIVE
To investigate the approach which could improve the survival rate of adult-to adult living donor liver transplantations, that right lobe liver grafts were performed by a modified technique.


METHODS
During from March to June 2005, 13 patients underwent the living donor liver transplantation with right lobe grafts via the improved surgical techniques including the reconstruction of right hepatic vein; the tributaries of the middle hepatic vein were reconstructed by interpositioning a vein grafts; the anastomosis of the hepatic arteries and bile ducts. All cases underwent the direct anastomosis of right hepatic vein and IVC, of whom 5 cases were added with the reconstructions of right inferior hepatic vein, and other 5 cases added with reconstructing the tributaries of the middle hepatic vein by interpositing a vein graft to provide sufficient venous outflow.


RESULTS
No donor suffered from severe complication or death. Four complications occurred in recipients who got the hepatic artery thrombosis (1 case), bile leakage (1 case), right subphrenic abscess (1 case) or pulmonary infection (1 case) respectively. The recipient with pulmonary infection died of MOF. The graft organ and recipient weight ratio (GRWR) were between 0.72% and 1.24%, that the ratios of 9 cases was < 1.0% and 2 cases < 0.8%, with no "small-for-size syndrome" occurred.


CONCLUSIONS
The improved surgical techniques, especially the reconstruction of hepatic vein to provide sufficient venous outflow, can make the adult-to-adult living donor liver transplantation with right lobe liver grafts become a relatively safe operation and prevent the "small-for-size syndrome".
The Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
Lü-nan
LN
Yan
Bo
B
Li
Yong
Y
Zeng
Tian-tu
TT
Wen
Ji-chun
JC
Zhao
Wen-tao
WT
Wang
Jia-ying
JY
Yang
Ming-qing
MQ
Xu
Yu-kui
YK
Ma
Zhe-yu
ZY
Chen
Hong
H
Wu
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006503:Hepatic Veins / Q000601:surgery*; D006801:Humans; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D014656:Vascular Surgical Procedures / Q000379:methods