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Volume regeneration after right liver donation
Author(s) -
Hata Shojiro,
Sugawara Yasuhiko,
Kishi Yoji,
Niiya Takashi,
Kaneko Junichi,
Sano Keiji,
Imamura Hiroshi,
Kokudo Norihiro,
Makuuchi Masatoshi
Publication year - 2004
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.20006
Subject(s) - medicine , hepatectomy , liver regeneration , trunk , vein , regeneration (biology) , liver transplantation , surgery , survival rate , resection , transplantation , biology , ecology , microbiology and biotechnology
After right hepatectomy with the middle hepatic vein trunk for a graft, the venous outflow in segment IV is disturbed. There are limited data, however, regarding the effect of middle hepatic vein deprivation on liver regeneration or functional recovery. Living donors who underwent right hepatectomy with preservation of the middle hepatic vein (Group A, n = 58) and those deprived of the middle hepatic vein (Group B, n = 13) were reviewed. When the donor was under 50 years old and the remnant left liver was estimated to be more than 35% of the whole liver, right liver graft harvesting with the middle hepatic vein trunk was considered. Volume regeneration of segments I–III, segment IV, and overall liver volume was assessed at the third postoperative month using computed tomography. The regeneration rate of segment IV was significantly impaired in Group B donors compared with that in Group A donors (125% vs. 45%, P = 0.008). In contrast, the regeneration rate of segments I –III was significantly higher than that in Group A (208% vs. 263%, P = 0.004). There was no significant difference in the regeneration rate of the whole left liver or functional recovery between groups. Multivariate analysis revealed that the resection type (group) was a significant predictive factor for the regeneration rate of segments I–III and segment IV. When deprived of the middle hepatic vein, liver regeneration of segment IV was impaired but was compensated for by the regeneration of segments I–III. In conclusion, extended right hepatectomy can be safely performed with careful preoperative consideration using these criteria. (Liver Transpl 2004;10:65–70.)