title: The changes of the medial right lobe, transplanted with left lobe liver graft from living donors.
abstract: BACKGROUND
  Procurement of left lobe (LL) living donor graft with medial right lobe (mRL) might be an innovative technique.
  
  
  METHODS
  The grafts were procured from a living donor, exposing the right anterior Glissonean pedicles, after confirmation of the demarcation line by test-clamping of the right Glissonean pedicle. Based on serial computed tomography, the increase in the graft volume (GV) after addition of mRL and changes in volumes were evaluated.
  
  
  RESULTS
  The addition of mRL (n=7) increased GV by 48+/-9 g, which corresponded to a 4% increase in GV-to-standard liver volume ratio. After transplantation, mRL volume has increased in all cases. The regeneration rate of the mRL and other LL segments 1 month after transplantation was 61%+/-18% and 146%+/-15%, respectively. Viable hepatic parenchyma with marginal bile duct dilatations in transplanted mRL was observed in all the cases. Marginal enhancement was observed in those cases with promoted regeneration of transplanted mRL. In the cranial part of the mRL, portal branching from the left portal vein, over the middle hepatic vein, was observed in all cases.
  
  
  CONCLUSIONS
  This technique affords an increase in GV in living donor LL procurement, and should increases the application of LL grafts in living donor liver transplantation.
authors.affiliation: Department of Surgery, The University of Tokushima, Tokushima, Japan. tikesurg@yahoo.co.jp
authors.forename: Toru
authors.initials: T
authors.lastname: Ikegami
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Shimada
authors.forename: Satoru
authors.initials: S
authors.lastname: Imura
authors.forename: Yuji
authors.initials: Y
authors.lastname: Soejima
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Yoshizumi
authors.forename: Jun
authors.initials: J
authors.lastname: Hanaoka
authors.forename: Yuji
authors.initials: Y
authors.lastname: Morine
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
mesh_terms: D000328:Adult; D007839:Functional Laterality; D006801:Humans; D008099:Liver / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000473:pathology; D016031:Liver Transplantation / Q000502:physiology*; D019520:Living Donors; D017741:Survivors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome