title: Reconstructing middle hepatic vein tributaries in right-lobe living donor liver transplantation.
abstract: OBJECTIVE
  To investigate the effectiveness of our technique and policy in reconstructing middle hepatic vein (MHV) tributaries of patients undergoing right-lobe living donor liver transplantation (LDLT).
  
  
  METHODS
  From January 2001 to December 2010, 186 adult patients underwent right-lobe LDLT without the MHV. Patients were divided into two groups: group A (n = 71) and group B (n = 115) without or with the MHV tributaries reconstruction. We evaluated the serum liver function markers after transplantation and monitored vascular flow in the graft and interpositional vein by Doppler ultrasonography.
  
  
  RESULTS
  The cumulative 1-, 3-, 5-year graft and patient survival rates were not significant between group A and group B (p = 0.287 and p = 0.258). Biliary complications appeared to be more frequent in group A than in group B (16.9 vs. 5.2%, p = 0.009). Liver function impairment was found in patients without MHV reconstruction and those with occluded interpositional vessels early after transplantation. The cumulative 1-, 3-, 6- and 12-month patency rate of the interpositional veins was 81.51, 79.60, 74.69 and 72.68%, respectively.
  
  
  CONCLUSIONS
  The reconstruction technique based on our policy ensures excellent outflow drainage and favorable recipient outcome, while better criteria for MHV reconstruction should be established.
authors.affiliation: Department of Liver and Vascular Surgery, West China Hospital of Sichuan University, Chengdu, PR China.
authors.forename: Peixian
authors.initials: P
authors.lastname: Chen
authors.forename: Wentao
authors.initials: W
authors.lastname: Wang
authors.forename: Lunan
authors.initials: L
authors.lastname: Yan
authors.forename: Tianfu
authors.initials: T
authors.lastname: Wen
authors.forename: Bo
authors.initials: B
authors.lastname: Li
authors.forename: Jichun
authors.initials: J
authors.lastname: Zhao
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D002681:China; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006503:Hepatic Veins / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008102:Liver Circulation / Q000502:physiology*; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods; D055815:Young Adult