Maximizing venous outflow after right hepatic living donor liver transplantation with a venous graft patch.
Between March 2002 and September 2004, 36 patients at Mie University Hospital underwent living donor liver transplantation (LDLT) of a right lobe graft without the middle hepatic vein. The patients were divided into two groups: group I (n = 25) received ordinary hepatic vein anastomoses, and group II (n = 11) received a venous graft patch in the subsequent procedure. Between groups, we compared hepatic vein blood flow (ultrasound), liver volume (CT scan), laboratory data, and ascitic fluid volume. Outflow block developed as a complication in 1 patient in group I. Hepatic vein blood flow on postoperative day (POD) 3 was significantly better in group II, and hepatic vein waveforms of most group II patients showed the triphasic pattern, especially on PODs 3 and 5. The total bilirubin and aspartate aminotransferase values on POD 1 were significantly better in group II, and daily ascitic fluid volume on PODs 3 and 5 was significantly lower in group II. Thus, modified venoplasty with a graft patch in the right hepatic LDLT not only improved hepatic vein hemodynamics (based on the ultrasound findings), but also improved liver function and decreased daily ascitic fluid volume.
Mizuno
Shugo
S
Department of Surgery, Mie University School of Medicine, Tsu, Japan. shugo.mizuno@sergery.ufl.edu
Sanda
Ryo
R
Hori
Tomohide
T
Yagi
Shintaro
S
Iida
Taku
T
Usui
Masanobu
M
Sakurai
Hiroyuki
H
Tabata
Masami
M
Isaji
Shuji
S
Uemoto
Shinji
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006439:Hemodynamics; D006498:Hepatectomy; D006503:Hepatic Veins / Q000601:surgery*; D006801:Humans; D008102:Liver Circulation; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D014652:Vascular Diseases / Q000601:surgery*; D014656:Vascular Surgical Procedures