title: Living donor right hepatectomy with inclusion of the middle hepatic vein: outcome in 200 donors.
abstract: Venous congestion of segments V and VIII of the graft is observed frequently in right-lobe living donor liver transplants (LDLT) without middle hepatic vein (MHV) drainage. It can cause graft dysfunction and failure. Inclusion of the MHV in the right lobe graft allows optimal venous drainage but can pose adverse effects for the donor. From May 2005 to April 2011, we performed 202 right-lobe LDLTs using grafts that all (except two) contained the MHV. The mean duration of donor surgery was 558±132 minutes (median 540, range 332-1100), and estimated blood loss 441±309 mL (median 350, range 35-3200). No donor was admitted to the intensive care unit postoperatively. The mean hospital stay was 8.7±2.1 days (median 8, range 6-22). Postoperatively, 39 donors (19.5%) experienced Clavien grade I and II complications, mostly minor wound infections or massive ascites necessitating diuretic therapy. Seven (3.5%) donors displayed Clavien grade III complications, including five bile leakages requiring endoscopic retrograde biliary drainage and two abdominal wound dehiscences requiring repair under general anesthesia. There was no donor death. In conclusion, inclusion of the MHV in a right-lobe LDLT was safe for most donors.
authors.affiliation: Organ Transplantation Center, Department of Surgery, China Medical University Hospital, Taichung, Taiwan.
authors.forename: H-R
authors.initials: HR
authors.lastname: Yang
authors.forename: L-B
authors.initials: LB
authors.lastname: Jeng
authors.forename: P-C
authors.initials: PC
authors.lastname: Li
authors.forename: C-C
authors.initials: CC
authors.lastname: Lee
authors.forename: K-S
authors.initials: KS
authors.lastname: Poon
authors.forename: T-H
authors.initials: TH
authors.lastname: Chen
authors.forename: C-C
authors.initials: CC
authors.lastname: Yeh
authors.forename: H-C
authors.initials: HC
authors.lastname: Lai
authors.forename: W-P
authors.initials: WP
authors.lastname: Su
authors.forename: C Y
authors.initials: CY
authors.lastname: Peng
authors.forename: Y-F
authors.initials: YF
authors.lastname: Chen
authors.forename: Y-J
authors.initials: YJ
authors.lastname: Ho
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods*; D006503:Hepatic Veins / Q000637:transplantation*; D006801:Humans; D008102:Liver Circulation; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D012086:Reoperation; D018570:Risk Assessment; D012307:Risk Factors; D013624:Taiwan; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects; D055815:Young Adult