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Reconstruction of the middle hepatic vein tributary in a right lateral sector graft
Author(s) -
Hashimoto Takuya,
Sugawara Yasuhiko,
Kishi Yoji,
Akamatsu Nobuhisa,
Matsui Yuichi,
Kokudo Norihiro,
Makuuchi Masatoshi
Publication year - 2005
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.20349
Subject(s) - medicine , surgery , liver transplantation , vein , tributary , transplantation , cardiology , cartography , geography
Abstract A right lateral sector graft (RLSG) was devised to overcome graft‐size disparity in living donor liver transplantation (LDLT). When the RLSG has a middle hepatic vein (MHV) tributary, which drains a significant part of segment VI, the MHV tributary (V6) should be reconstructed to avoid congestion of the RLSG. In the donor operation, congestive area of segment VI was identified by 5 minutes of simultaneous clamping of V6 and the hepatic artery to the right lateral sector. An RLSG was harvested, preserving the V6 orifice. After plastic surgery of outflow veins including V6 using venous grafts, the RLSG was implanted into the recipient. In 19 patients who received RLSG in our institution, 2 RLSGs required V6 reconstruction. The postoperative courses of these two recipients and donors were uneventful. In conclusion, the present technique might be useful to avoid complications due to congestion and poor function of the relevant graft area and might help to expand the indications for RLSG. (Liver Transpl 2005;11:309‐313.)