title: Middle hepatic vein allocation in adult right lobe living donor liver transplantation.
abstract: BACKGROUND
  When adult-to-adult living donor liver transplantation (LDLT) using the right lobe is carried out, there is disagreement between different centers as to whether the middle hepatic vein (MHV) is included or retained by the donor.
  
  
  METHODS
  Ninety-two cases of adult-to-adult LDLT were performed between January 2007 and December 2010 using a right lobe graft. A protocol for MHV allocation was applied according to the donor's remnant liver volume, overall graft/recipient weight ratio (GRWR), and anatomic characteristics of the hepatic vein. Among these cases, there were 44 cases with MHV and 48 cases without MHV. No blood products were used during donor operations, and there was no occurrence of death or small-for-size syndrome after operations.
  
  
  RESULTS
  There were statistical differences between Groups I and II according to the ages of the recipients, the actual GRWR, the weights of grafts, the cold storage time of grafts, etc. All patients recovered smoothly; one-, three-, and five-yr survival rates of patients were 96.7%, 92.4%, and 92.4% and of grafts were 95.7%, 91.3%, and 91.3%, respectively.
  
  
  CONCLUSIONS
  With a reasonable allocation protocol and precise evaluation, either MHV harvested or MHV retained to the donor during adult-to-adult LDLT using the right lobe can achieve good outcome.
authors.affiliation: Department of Hepatobiliary Surgery, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, China; Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
authors.forename: Zhu
authors.initials: Z
authors.lastname: Zhijun
authors.forename: Gao
authors.initials: G
authors.lastname: Wei
authors.forename: Wei
authors.initials: W
authors.lastname: Lin
authors.forename: Zeng
authors.initials: Z
authors.lastname: Zhigui
authors.forename: Yang
authors.initials: Y
authors.lastname: Tao
authors.forename: Sun
authors.initials: S
authors.lastname: Liying
authors.forename: Qu
authors.initials: Q
authors.lastname: Wei
authors.forename: Sun
authors.initials: S
authors.lastname: Jisan
authors.forename: Lv
authors.initials: L
authors.lastname: Yi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006503:Hepatic Veins / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008099:Liver / Q000098:blood supply* / Q000473:pathology; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate; D055815:Young Adult
keywords: graft/recipient weight ratio; living donor liver transplantation; middle hepatic vein; outcome; remnant liver volume