Living donor right liver lobe transplantation with or without inclusion of the middle hepatic vein: analysis of complications.
BACKGROUND
For living-related liver transplantation, harvesting a right hepatic graft that includes the middle hepatic vein (MHV) has been recommended to improve venous drainage of the graft. However, it may result in congestion of the donor's remaining segment IV, increasing the potential risk to the donor. This study aimed to compare safety levels for liver donors during procedures with or without removal of the MHV.


METHODS
A total of 68 living donor liver transplantations were performed from March 2001 to May 2007. In 39 procedures, the MHV was not included in the graft (group A), and in 29 the MHV was included in the graft (group B). The analyzed data included surgical time, use of blood derivatives, length of hospital stay, laboratory analyses, weight of the graft, and clinical complications.


RESULTS
No differences were observed regarding the need for blood derivatives or laboratory parameters. The frequency of postoperative complications was similar in the two groups, with 10 cases (25.6%) in group A and 7 cases (24.1%) in group B (P=0.887). No deaths were seen. The rate of observed complications was 25% among living donors, most of them being managed without surgical intervention.


CONCLUSIONS
The inclusion of the MHV does not add morbidity in living donors in selected cases.
Department of General and Transplantation Surgery, Hospital Beneficência Portuguesa, São Paulo, SP, Brazil.
Jorge Marcelo Padilla
JM
Mancero
Adriano Miziara
AM
Gonzalez
Marcelo Augusto Fontenelle
MA
Ribeiro
Gilberto
G
Peron
Raul Carlos
RC
Wahle
Francisco Leôncio
FL
Dazzi
Adávio
A
de Oliveira e Silva
Luiz Augusto Carneiro
LA
D'Albuquerque
D000328:Adult; D000465:Algorithms; D005260:Female; D006503:Hepatic Veins; D006801:Humans; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D020858:Tissue and Organ Harvesting / Q000009:adverse effects* / Q000379:methods*