The success of adult right-lobe living donor liver transplants (RLDLT) would not have been possible without the experience of the early pioneers of pediatric living donor liver transplants (LDLT). Our experience with 95 RLDLTs from July, 2000 to May, 2002 at a single institution is reported with specific emphasis on arterial reconstruction. The evolution of technique using the autogenous Y extension graft and the reverse extension bifurcated graft for arterial revascularization, which we believe has reduced the incidence of hepatic artery thrombosis, is described. Outcome and the incidence of hepatic artery thrombosis are reported. (Liver Transpl 2003;9: 570-574.)
Hernias involving the retroperitoneum are unusual. The most common of these are the paraduodenal hernias. A retroperitoneal hernia occurring from a lateral defect in the colonic retroperitoneal attachments is presented. We believe that this case represents a newly recognized variant of retroperitoneal hernias.
Right-lobe living-donor liver transplantation (LDLT) has emerged as an innovative method to combat the ever-expanding United Network for Organ Sharing waiting list. Although still in its early years of development, certain centers have had extensive experience with outcomes equal to that of traditional cadaveric liver transplantation. As experience is gained, the selection criteria for both donors and recipients have evolved. To combat the unique obstacles of transplanting a segmental graft, various techniques have been proposed and/or refined. The optimal method remains to be determined while taking into consideration that each graft can pose its own unique challenge due to complex anatomical variation. The authors' goal is to review the development of LDLT and to discuss the current issues under debate. REVIEWS Several donor resections have been safely performed for adult recipients over the years, but the right lobe has emerged as the preferred graft.
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