title: Use of middle hepatic vein in right lobe living donor liver transplantation.
abstract: The harvesting of the middle hepatic vein (MHV) with the right lobe graft for living-donor liver transplantation allows an optimal venous drainage for the recipient; however, it is an extensive operation for the donor. This is a prospective, nonrandomized study evaluating liver functions and early clinical outcome in donors undergoing right hepatectomy with or without MHV harvesting. From August 2005 to July 2007, a total of 100 donor right hepatectomies were performed with (n = 49) or without (n = 51) the inclusion of the MHV. The decision to take MHV was based on an algorithm that considers various donor and recipient factors. There was no donor mortality in donors in either group. Overall complication rate was higher in MHV (+) donor group, however when remnant liver volume was kept above 30%, complication rates were similar between the groups. The results of this study show that right hepatectomy including the MHV neither affects morbidity nor impairs early liver function in donors when remnant volume is kept above 30%. The decision, therefore, of the extent of right lobe donor hepatectomy should be tailored to the particular conditions considering the graft quality and metabolic demand of the recipient.
authors.affiliation: Florence Nightingale Hospital, Center for Organ Transplantation, Abide-i Hurriyet Caddesi No: 290 Sisli, Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Dayangac
authors.forename: C Burcin
authors.initials: CB
authors.lastname: Taner
authors.forename: Deniz
authors.initials: D
authors.lastname: Balci
authors.forename: Izzet
authors.initials: I
authors.lastname: Memi
authors.forename: Onur
authors.initials: O
authors.lastname: Yaprak
authors.forename: Baris
authors.initials: B
authors.lastname: Akin
authors.forename: Cihan
authors.initials: C
authors.lastname: Duran
authors.forename: Refik
authors.initials: R
authors.lastname: Killi
authors.forename: Omer
authors.initials: O
authors.lastname: Ayanoglu
authors.forename: Yildiray
authors.initials: Y
authors.lastname: Yuzer
authors.forename: Yaman
authors.initials: Y
authors.lastname: Tokat
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000465:Algorithms; D001219:Aspartate Aminotransferases / Q000097:blood; D046148:Donor Selection / Q000379:methods; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods; D006503:Hepatic Veins / Q000601:surgery* / Q000637:transplantation*; D006801:Humans; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods* / Q000502:physiology; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase