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Abstract
Background. The surgical procedures to reconstruct the hepatic veins differ according to their
anatomic variations to obtain the optimal graft volume for the recipient. This is
an overview of the procedures used in our 25 living related liver transplantations.
Methods. The donor/recipient body weight ratio ranged widely from 1.2:1 to 9.6:1 (5.3 ± 0.5:1,
mean ± SEM).
Results. The graft weight/recipient body weight was 2.40% ± 0.27%. Graft components, which
were determined by the optimal graft volume, and their drainage veins were the following:
(1) segments 2 and 3 (S2+3) were used in 13 cases, 11 with the left hepatic vein (LHV) and two with the LHV
and a partial drainage vein of S3; (2) S2+3 and a part of S4 in eight cases, seven with LHV and one with LHV and a partial drainage vein of S4; (3) S2+3+4 in three cases, with the common trunk of LHV and middle hepatic vein in all cases;
and (4) S5+6+7+8 in one case with right hepatic vein. In two of three cases in which the graft had
two drainage veins, the two vessels were reformed to have a common anastomotic orifice
by the back-table plastic surgery procedure. In the other case in which the procedure
could not be performed, two separate anastomoses of the individual vessels were performed
successfully. Although stenosis of the reconstructed hepatic veins occurred four times
in two cases at 3 months or more after transplantation, all incidences could be completely
repaired by balloon dilatation.
Conclusions. These results show that, with careful consideration of the hepatic vein reconstruction,
pediatric patients can receive optimal volume grafts from living donors.
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Article info
Publication history
Accepted:
September 18,
1992
Footnotes
☆Supported in part by grants from the Scientific Research Fund of the Ministry of Education and by a grant-in-aid for cancer research from the Ministry of Health and Welfare.
Identification
Copyright
© 1993 Published by Elsevier Inc.
