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Volumetry-based selection of right posterior sector grafts for adult living donor liver transplantation.

Authors
Kim, BW; Xu, W; Wang, HJ; Park, YK; Lee, K; Kim, MW
Citation
Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 17(9):1046-1058, 2011
Journal Title
Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
ISSN
1527-64651527-6473
Abstract
To determine the feasibility of volumetric criteria without anatomic exclusion for the selection of right posterior sector (RPS) grafts for adult-to-adult living donor liver transplantation (LDLT), we reviewed and compared our transplant data for RPS grafts and right lobe (RL) grafts. Between January 2008 and September 2010, adult-to-adult LDLT was performed 65 times at our institute; 13 of the procedures (20%) were performed with RPS grafts [the posterior sector (PS) group], and 39 (60%) were performed with RL grafts (the RL group). The volumetry of the 13 RPS donor livers showed that the RPS volume was 39.8% ± 7.6% of the total liver volume. Ten of the 13 donors had to donate RPS grafts because the left liver volume was inadequate. All donor procedures were performed successfully, and all donors recovered from hepatectomy. However, longer operative times were required for the procurement of RPS grafts versus RL grafts (418 ± 40 versus 345 ± 48 minutes, P < 0.001). The postoperative recovery of liver function was smoother for the donors of the PS group versus the donors of the RL group. The RPS grafts had significantly smaller hepatic artery and bile duct openings than the RL grafts. All recipients with RPS grafts survived LDLT. No recipients experienced vascular graft complications or small-for-size graft dysfunction. There were no significant differences in the incidence of posttransplant complications between the donors and recipients of the PS and RL groups. The 3-year graft survival rates were favorable in both groups (100% in the PS group versus 91% in the RL group). In conclusion, the selection of RPS grafts by volume criteria is a feasible strategy for an adult-to-adult LDLT program.
MeSH terms
AdolescentAdultFemaleFollow-Up StudiesGraft SurvivalHepatectomy/methodsHumansLiver/physiopathologyLiver Transplantation/*methodsLiving DonorsMaleMiddle Aged*Organ SizeRetrospective StudiesTissue and Organ Procurement/*methodsTreatment Outcome
DOI
10.1002/lt.22338
PMID
21594965
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Surgery
AJOU Authors
김, 봉완왕, 희정박, 용근김, 명욱
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