Clinical significance of detailed preoperative evaluation on donors in right lobe living donor liver transplantation.
OBJECTIVE
To investigate the clinical importance of detailed preoperative evaluation on donors of right lobe graft in living donor liver transplantation.


METHODS
Between January 2001 and August 2006, 106 potential donors were screened and evaluated. Evaluation focused on imaging study of hepatic vascular system, bile duct system, hepatic volumety and hepatic steatosis.


RESULTS
A total of 81 women (77.88%) and 23 men (22.12%) were evaluated with 51 donors participating. 55 potential donors were rejected. One donor failed to complete donation hepatectomy due to 40% macrovesicular steatosis found during operation. Variation of portal vein and hepatic artery could be found with evaluation. However, variations of hepatic veins especially the tributaries of middle hepatic vein and right hepatic bile duct showed on CT scan were not concordant with those at the cut surface of the liver graft. All the 50 right lobe grafts did not include middle hepatic vein, weighing 400-850 g (media 550 g), accounting for 31.74-71.68% (mean 45.35%) of standard liver volume (SLV) of the recipients. Donor morbidity, including all complications, was 8% with no mortality. All the donors recovered uneventfully.


CONCLUSIONS
Detailed evaluation for hepatic lobar volume, vascular anatomy, virtual resection planes and morphologic features is of clinical importance in the selection of suitable donor in living right liver transplantation.
Zhang
Yu
Y
Division of Liver Transplantation, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China. zhangyu.wwww@yahoo.com.cn
Wen
Tianfu
T
Yan
Lunan
L
Chen
Zheyu
Z
Li
Bo
B
Zeng
Yong
Y
Zhao
Jichun
J
Wang
Wentao
W
Yang
Jiayin
J
Xu
Mingqing
M
Ma
Yukui
Y
D000328:Adult; D000368:Aged; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods*; D006503:Hepatic Veins / Q000033:anatomy & histology; D006801:Humans; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care