Using recipient's middle hepatic vein for drainage of the right paramedian sector in right liver graft.
BACKGROUND
Congestion in the right paramedian sector of a right liver graft without a middle hepatic vein (MHV) may lead to graft dysfunction. To solve this problem, we have developed a technique for reconstructing the MHV tributaries of the right liver grafts by using the preserved recipient's native MHV trunk.


METHODS
Between 2005 and 2007, among 34 right liver graft liver transplant patients with significant MHV tributaries (>5 mm in diameter), 21 patients underwent right liver graft living-donor liver transplantation: draining MHV tributaries with recipient's native MHV trunk. We evaluated the patency of the reconstructed MHV tributaries, graft regeneration, and graft survival.


RESULTS
The 3-month patency rates of the reconstructed V8 and V5 were 92% and 76%, respectively. The 1-year survival rate and the regeneration index of the right paramedian sector 6 months after transplantation were higher in patients with reconstructed MHV tributaries than that for patients without reconstructed MHV tributaries.


CONCLUSIONS
The use of the recipient's MHV trunk for the reconstruction of the MHV tributaries of the right liver grafts is considered to be a valuable and a feasible strategy in right liver graft living-donor liver transplantation.
Tashiro
Hirotaka
H
Second Department of Surgery, Hiroshima University Hospital, Hiroshima, Japan. htashiro@hiroshima-u.ac.jp
Ohdan
Hideki
H
Itamoto
Toshiyuki
T
Fudaba
Yasuhiro
Y
Amano
Hironobu
H
Oshita
Akihiko
A
Ishiyama
Kohei
K
Ushitora
Yuichiro
Y
Irei
Toshimitsu
T
Ohira
Masahiro
M
Tahara
Hiroyuki
H
Banshoudani
Masataka
M
Tanimoto
Yoshisato
Y
Ishufuro
Minoru
M
Asahara
Toshimasa
T
D000368:Aged; D005260:Female; D006503:Hepatic Veins / Q000601:surgery*; D006801:Humans; D008099:Liver / Q000098:blood supply* / Q000601:surgery; D008102:Liver Circulation; D008115:Liver Regeneration; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome