Title: Clinical importance of preoperative evaluation on donors in living donor's right liver transplantation
Abstract: Objective To investigate the necessity of detailed preoperative evaluation on donors in living donor's right liver transplantation. Methods Data of 23 living donors of right hepatic lobe graft from January 2002 to November 2005 were retrospectively studied. Preoperative evaluation included donor's general condition, imaging study of hepatic vasculature and bile duct system, hepatic volumetry and hepatic steatosis. The right lobe grafts were obtained by transecting the liver without the inclusion of the middle hepatic vein. The standard liver volume (SLV) and the ratio of left lobe volume to SLV were calculated. Results Portal vein had three major branches in 4 cases, accessory right hepatic vein larger than 5 mm in diameter was found in 7 cases, 5 cases had large vein draining into middle hepatic vein (V_5), 4 cases had V_8 and 3 case had variation of right bile duct. Intraoperatively, 9 cases were found to have accessory right hepatic vein, 5 had V_5, 5 had V_8 and 4 with variations of the right bile ducts. There were 2 cases with slight steatosis. The mean operative blood loss was 462 ml during the process of grafting. The volume of right hepatic lobe graft ranged from 39. 7% to 69.5% of SLV with the ratio of residual left liver from 30. 5% to 60. 3%. On postoperative day 1 the impairment on donors liver functions was universal which subsided at the end of the first week. Complications included intraabdominal bleeding in 1 case, chyloperitoneum in one, and wound seatoses in 2. All donors recovered smoothly. Conclusion Detailed preoperative evaluation of hepatic vasculature and bile duct system, hepatic volumetry and hepatic quality is of clinical importance in the selection of suitable donor in liver right liver transplantation.
Publication Year: 2006
Publication Date: 2006-01-01
Language: en
Type: article
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