title: Feasibility assessment for tailoring preservation of segment VIII hepatic vein during left liver graft procurement.
abstract: OBJECTIVE
  Procurement of left lobe (LL) graft occasionally induces large-sized hepatic venous congestion (HVC) at the remnant right liver. Isolated preservation of segment VIII vein (V8) could reduce this HVC, but it has been applied to only a small number of living donor operations to date.
  
  
  METHODS
  We investigated the indication of tailoring V8 preservation through the anatomical analyses and computer simulation in a large-volume donor pool. After setting up its surgical technique in 3 donor cases, we analyzed the liver anatomy of 147 LL graft donors.
  
  
  RESULTS
  We regarded the first anatomical condition as direct convergence of a large V8 branch on middle hepatic vein root, by which 27 livers were selected. The second was absence of complex hepatic vein branching at the graft cutting line, and 4 livers were excluded. The third was relatively large-sized HVC more than 35% of right lobe volume, and 11 livers were additionally excluded. Finally, 12 (8.2%) of 147 were left after 3-step selection processes. V8 preservation was estimated to reduce the total amount of HVC by 40%.
  
  
  CONCLUSIONS
  We think that tailoring V8 preservation seems to be indicated for 8.2% of LL graft donor livers according to the 3 anatomical conditions.
authors.affiliation: Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Shin
authors.initials: S
authors.lastname: Hwang
authors.forename: Sung-Gyu
authors.initials: SG
authors.lastname: Lee
authors.forename: Tae-Yong
authors.initials: TY
authors.lastname: Ha
authors.forename: Chul-Soo
authors.initials: CS
authors.lastname: Ahn
authors.forename: Kwang-Min
authors.initials: KM
authors.lastname: Park
authors.forename: Ki-Hun
authors.initials: KH
authors.lastname: Kim
authors.forename: Deok-Bog
authors.initials: DB
authors.lastname: Moon
authors.forename: Gi-Won
authors.initials: GW
authors.lastname: Song
authors.forename: Dong-Sik
authors.initials: DS
authors.lastname: Kim
authors.forename: Jae-Pil
authors.initials: JP
authors.lastname: Jung
mesh_terms: D000293:Adolescent; D000328:Adult; D003198:Computer Simulation; D005260:Female; D006503:Hepatic Veins / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008099:Liver / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000601:surgery; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D014021:Tissue Preservation / Q000379:methods*; D020858:Tissue and Organ Harvesting / Q000379:methods*; D009927:Tissue and Organ Procurement; D014057:Tomography, X-Ray Computed