Technical refinement preserving segment 4 to donor in extended right hepatectomy.
OBJECTIVE
Donor extended right hepatectomy, including the middle hepatic vein (MHV) and a part of segment 4 (Sg4), is performed to overcome inadequate graft for large adult recipient as resolving congestion of right anterior section. However, using this technique remnant donor liver is often too small. Here, we introduce a technical Modified extended right hepatectomy (MERH), in which the MHV was excavated preserving the entire Sg4 in the donor.


METHODS
We compared clinical outcomes between donors using our technique (n=12) that may result in Sg4 congestion, and right hepatectomy (RH, n=12) that may not. MERH was performed when the remnant donor liver had a volume exceeding 35% and showed no steatosis in preoperative imaging study.


RESULTS
No donor died, and there were no differences in operative time and postoperative recovery between the two groups (p>0.05). The regeneration of the remnant liver after MERH and RH were similar (160.2% vs. 187.7% at POD 10; 222.2% vs. 230.5% at 4 months) (p>0.05).


CONCLUSIONS
Our results show that MERH didn't impair recovery or liver regeneration in donors, and indicate that MERH will be useful in adult living donor liver transplantation.
Suh
Kyung-Suk
KS
Department of Surgery, Seoul National University, College of Medicine, Seoul, Korea. kssuh@plaza.snu.ac.kr
Yi
Nam-Joon
NJ
Cho
Jai Yong
JY
Kwon
Choon Hyuck
CH
Minn
Kyung Won
KW
Lee
Kuhn Uk
KU
D000328:Adult; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008099:Liver / Q000473:pathology* / Q000503:physiopathology*; D008111:Liver Function Tests; D008115:Liver Regeneration / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D017063:Outcome Assessment, Health Care; D020858:Tissue and Organ Harvesting / Q000379:methods*