Remain recipient partial liver during liver transplant after Hassab.
BACKGROUND
The Hassab procedure is the primary method for treating and preventing recurrent esophagogastric variceal bleeding in portal hypertension patients. These patients have worsening liver function and eventually require liver transplantation. Abnormal anatomical structures and severe tissue adhesion caused by the Hassab procedure increase the risks of transplantation. We investigated the safety and efficacy of retaining part of the left lateral hepatic lobe during transplantation.


METHODS
This retrospective study evaluated outcomes in 22 patients who underwent the Hassab procedure followed by liver transplantation. The patients were separated into two groups: group A (complete liver resection, n = 14) and group B (incomplete liver resection with left lateral remnant, n = 8). We statistically analyzed pre-, intra-, and post-operative variables in both groups.


RESULTS
Preoperative demographic data showed no significant differences between the groups. Operation time was significantly greater in group A (10.85 ± 0.79 h) than in group B (7.25 ± 0.59 h), and median blood loss (2807 ± 472 mL) was significantly greater in group A than in group B (1023 ± 141 mL, P < 0.05 for both). Overall complication rates were not significantly different; the 1- and 3-y survival rates were 85.7% and 71.4% for group A and 87.5% and 75.0% for group B, respectively (P > 0.05).


CONCLUSIONS
Retention of some left hepatic lobe tissue during liver transplantation after the Hassab procedure is safe and feasible because it increases the success rate by reducing surgical difficulty and time.
Key Laboratory of Living Donor Liver Transplantation of Ministry of Public Health, Department of liver surgery, First Affiliated Hospital of Nanjing Medical University; Nanjing, P.R. China.
Jianhua
J
Rao
Key Laboratory of Living Donor Liver Transplantation of Ministry of Public Health, Department of liver surgery, First Affiliated Hospital of Nanjing Medical University; Nanjing, P.R. China.
Yong
Y
Sun
Key Laboratory of Living Donor Liver Transplantation of Ministry of Public Health, Department of liver surgery, First Affiliated Hospital of Nanjing Medical University; Nanjing, P.R. China.
Haoming
H
Zhou
Key Laboratory of Living Donor Liver Transplantation of Ministry of Public Health, Department of liver surgery, First Affiliated Hospital of Nanjing Medical University; Nanjing, P.R. China.
Guoqiang
G
Li
Key Laboratory of Living Donor Liver Transplantation of Ministry of Public Health, Department of liver surgery, First Affiliated Hospital of Nanjing Medical University; Nanjing, P.R. China.
Xiaofeng
X
Qian
Key Laboratory of Living Donor Liver Transplantation of Ministry of Public Health, Department of liver surgery, First Affiliated Hospital of Nanjing Medical University; Nanjing, P.R. China.
Xuehao
X
Wang
Key Laboratory of Living Donor Liver Transplantation of Ministry of Public Health, Department of liver surgery, First Affiliated Hospital of Nanjing Medical University; Nanjing, P.R. China. Electronic address: zhangf@njmu.edu.cn.
Feng
F
Zhang
Key Laboratory of Living Donor Liver Transplantation of Ministry of Public Health, Department of liver surgery, First Affiliated Hospital of Nanjing Medical University; Nanjing, P.R. China. Electronic address: lvling@njmu.edu.cn.
Ling
L
Lu
D000328:Adult; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D016896:Treatment Outcome
Efficacy; Hassab procedure; Liver transplantation; Safety