Left Lobe Living Donor Liver Transplantation in Adults

Soejima, Yuji; Shirabe, Ken; Taketomi, Akinobu; Yoshizumi, Tomoharu; Uchiyama, Hideaki; Ikegami, Toru; Ninomiya, Mizuki; Harada, Noboru; Ijichi, Hideki; Maehara, Yoshihiko

doi:10.1111/j.1600-6143.2012.04022.x

Cited by 117 publications

(139 citation statements)

References 29 publications

Supporting

Mentioning

129

Contrasting

Unclassified

Order By: Relevance

“…We implemented the LDLT program in 1996 and have performed more than 400 LDLTs so far. In our experience, as observed in other transplantation centers, the incidence of postoperative complications after right hepatic donation was higher than that of left-sided hepatic donation (13,18). That is, a larger hepatectomy was considered complication-prone.…”

Section: Introductionsupporting

confidence: 70%

“…That is, a larger hepatectomy was considered complication-prone. Moreover, the recipient survival after left hepatic grafting was comparable to that after right hepatic grafting (13,18). We had strongly advocated the use of left-sided hepatic grafts for the sake of donor safety.…”

Section: Introductionmentioning

confidence: 94%

“…The safety of living liver donors is of paramount importance and this issue has been aggressively discussed so far (10)(11)(12)(13)(14)(15)(16). Although the liver has a capacity to regenerate, it is generally believed that the larger the resected liver parenchyma is, the more frequently postoperative complications will occur (13,14,17,18). We implemented the LDLT program in 1996 and have performed more than 400 LDLTs so far.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Revisiting the Safety of Living Liver Donors by Reassessing 441 Donor Hepatectomies: Is a Larger Hepatectomy Complication-Prone?

Uchiyama

Shirabe

Nakagawara

et al. 2014

American Journal of Transplantation

Self Cite

View full text Add to dashboard Cite

Section: Introductionsupporting

confidence: 70%

Section: Introductionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Revisiting the Safety of Living Liver Donors by Reassessing 441 Donor Hepatectomies: Is a Larger Hepatectomy Complication-Prone?

Uchiyama

Shirabe

Nakagawara

et al. 2014

American Journal of Transplantation

Self Cite

View full text Add to dashboard Cite

“…Grafts were selected as previously described (15). Left lobe grafts were used as the primary graft type if the desired graft volume/standard liver volume ratio (GV/SLV) was !35%.…”

Section: Introductionmentioning

confidence: 99%

Correlation Between Portal Vein Anatomy and Bile Duct Variation in 407 Living Liver Donors

Takeishi

Shirabe²,

Yoshida³

et al. 2015

American Journal of Transplantation

Self Cite

View full text Add to dashboard Cite

Our aim was to determine whether variant bile duct (BD) anatomy is associated with portal vein (PV) and/or hepatic artery (HA) anatomy. We examined the associations between BD anatomy and PV and/or HA anatomy in 407 living donor transplantation donors. We also examined whether the right posterior BD (RPBD) course was associated with the PV and/or HA anatomy. Variant PV, HA and BD anatomies were found in 11%, 25% and 25%, respectively, of 407 donors enrolled in this study. The presence of a variant BD was more frequently associated with a variant PV than with a normal PV (61% vs. 20%, p < 0.0001). By contrast, the presence of a variant HA was not associated with a variant BD. A supraportal RPBD was found in 357 donors (88%) and an infraportal RPBD was found in 50 donors (12%). An infraportal RPBD was significantly more common in donors with a variant PV than in donors with a normal PV (30% vs. 10%, p ¼ 0.0004). Variant PV, but not variant HA, anatomies were frequently associated with variant BD anatomy. Additionally, an infraportal RPBD was more common in donors with a variant PV than in donors with a normal PV.

show abstract

“…(12,13) A Kyushu group also pointed out that ESLD patients with high MELD scores are not suitable candidates for LDLT using a left lobe graft because of poor postoperative prognosis. (9,14) A study in Hong Kong reported that acute or chronic hepatitis B virus (HBV)-infected ESLD patients can be rescued by right lobe with middle hepatic vein (MHV) graft in their LDLT series. (15) Graft volume and recipient prognosis are thought to be correlated, and the minimal graft volume required…”

mentioning

confidence: 99%

Minimum graft size calculated from preoperative recipient status in living donor liver transplantation

et al. 2016

View full text Add to dashboard Cite

Small-for-size graft syndrome is an inevitable complication in living donor liver transplantation (LDLT). We hypothesized that graft weight (GW) measured after graft procurement is one of the variables predicting postoperative graft function. A total of 138 consecutive recipients of adult-to-adult LDLT between March 1999 and October 2014 were included in this study. We investigated the factors associated with small-for-size-associated graft loss (SAGL) to determine the GW required for each patient. Both preoperatively assessed and postoperatively obtained risk factors for SAGL were analyzed in univariate and multivariate logistic regression analysis. Twelve (8.8%) of the transplant recipients had SAGL. In multivariate logistic regression analyses using preoperatively assessed variables, the preoperative Model for End-Stage Liver Disease (MELD) score (P < 0.001) and actual GW/recipient standard liver volume (SLV) ratio (P 5 0.008) were independent predictors of SAGL. Living donor liver transplantation (LDLT) has been established as a lifesaving treatment for end-stage liver disease (ESLD) and acute liver failure, though it is not considered to be as ideal a treatment as deceased donor liver transplantation due to substantial risk of mortality for living donors.(1-6) Morbidities among living donors are reported to be more frequent in right lobectomy than left lobectomy or left lateral sectionectomy. (7) Many transplant programs use a left lobe graft in LDLT to minimize morbidities in living donors. (8,9) However, despite excellent postoperative results using the left lobe, it is not applicable to a certain group of LDLT candidates. We previously reported that a high preoperative Model for End-Stage Liver Disease (MELD) score (10,11) was associated with postoperative graft failure. (12,13) A Kyushu group also pointed out that ESLD patients with high MELD scores are not suitable candidates for LDLT using a left lobe graft because of poor postoperative prognosis. (9,14) A study in Hong Kong reported that acute or chronic hepatitis B virus (HBV)-infected ESLD patients can be rescued by right lobe with middle hepatic vein (MHV) graft in their LDLT series. (15) Graft volume and recipient prognosis are thought to be correlated, and the minimal graft volume required

show abstract

Left Lobe Living Donor Liver Transplantation in Adults

Cited by 117 publications

References 29 publications

Revisiting the Safety of Living Liver Donors by Reassessing 441 Donor Hepatectomies: Is a Larger Hepatectomy Complication-Prone?

Revisiting the Safety of Living Liver Donors by Reassessing 441 Donor Hepatectomies: Is a Larger Hepatectomy Complication-Prone?

Correlation Between Portal Vein Anatomy and Bile Duct Variation in 407 Living Liver Donors

Minimum graft size calculated from preoperative recipient status in living donor liver transplantation

Contact Info

Product

Resources

About