title: Phrenic vein dissection in partial liver graft harvesting.
abstract: OBJECTIVE
  Despite the impressive results of living donor liver transplantation, hepatic venous reconstruction remains a controversial component.
  
  
  METHODS
  A total of 211 consecutive donor hepatectomies were performed. The proximal route of the hepatic vein was exposed by dissection of the connective tissue around the hepatic vein and by dividing and ligating all of the inferior phrenic veins that open into the hepatic vein, into the confluence of the hepatic vein and inferior vena cava, or directly into the inferior vena cava.
  
  
  RESULTS
  In the 114 left-side hepatectomy procedures, the number of divided left inferior phrenic veins ranged from 1 to 4 and the diameters of the left and middle hepatic veins ranged from 7 to 33mm. For the 97 right-side procedures, the number of divided right inferior phrenic veins ranged from 1 to 4 and the diameters of right hepatic veins ranged from 9 to 34mm. This maneuver safely allowed for the safe exposure of all trunks and routes of the hepatic veins and the suprahepatic portion of the inferior vena cava.
  
  
  CONCLUSIONS
  Our technique is useful for obtaining a wide ostium and a sufficient length of the hepatic vein for grafts obtained from living donors.
authors.affiliation: Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine University of Tokyo, Japan.
authors.forename: Ender
authors.initials: E
authors.lastname: Dulundu
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Sugawara
authors.forename: Yoji
authors.initials: Y
authors.lastname: Kishi
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Akamatsu
authors.forename: Norihiro
authors.initials: N
authors.lastname: Kokudo
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Makuuchi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004210:Dissection; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006503:Hepatic Veins / Q000601:surgery; D006801:Humans; D008026:Ligation; D008099:Liver / Q000098:blood supply*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D020858:Tissue and Organ Harvesting / Q000379:methods