Using Recipient's Middle Hepatic Vein for Drainage of the Right Paramedian Sector in Right Liver Graft

作者：Tashiro Hirotaka^*; Ohdan Hideki; Itamoto Toshiyuki; Fudaba Yasuhiro; Amano Hironobu; Oshita Akihiko; Ishiyama Kohei; Ushitora Yuichiro; Irei Toshimitsu; Ohira Masahiro; Tahara Hiroyuki; Banshoudani Masataka; Tanimoto Yoshisato; Ishufuro Minoru; Asahara Toshimasa

来源：Transplantation, 2008, 86(11): 1565-1571.

DOI：10.1097/TP.0b013e31818bc211

• Living-donor liver transplantation
• Middle hepatic vein
• Right liver graft
• Vascular closure system

Background. Congestion in the right paramedian sector of a right liver graft without a middle hepatic vein (MHV) may lead to graft dysfunction. To solve this problem, we have developed a technique for reconstructing the MHV tributaries of the right liver grafts by using the preserved recipient's native MHV trunk.
Methods. Between 2005 and 2007, among 34 right liver graft liver transplant patients with significant MHV tributaries (>5 mm in diameter), 21 patients underwent right liver graft living-donor liver transplantation: draining MHV tributaries with recipient's native MHV trunk. We evaluated the patency of the reconstructed MHV tributaries, graft regeneration, and graft Survival.
Results. The 3-month patency rates of the reconstructed V8 and V5 were 92% and 76%, respectively. The 1-year survival rate and the regeneration index of the right paramedian sector 6 months after transplantation were higher in patients with reconstructed MHV tributaries than that for patients without reconstructed MHV tributaries.
Conclusion. The use of the recipient's MHV trunk for the reconstruction of the MHV tributaries of the right liver grafts is considered to be a valuable and a feasible strategy in right liver graft living-donor liver transplantation.

• 出版日期2008-12-15