The influence of donor age to graft volume increase rate in living donor liver transplantation

Hirata, Masaru; Harihara, Yasushi; Kitamura, Tadashi; Hisatomi, S; Kato, Motohiro; Dowaki, Shoichi; Mizuta, Kazue; Sugawara, Yasuhiko; Kita, Yoshiaki; Kubota, Keiichi; Takayama, Tadatoshi; Kawarasaki, Hideo; Hashizume, Kohei; Makuuchi, Masatoshi

doi:10.1016/s0041-1345(00)02534-3

Cited by 15 publications

(12 citation statements)

References 2 publications

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“…We made a limitation of age less than 50 years for the donor for extended right hepatectomy. Previous studies reported that liver grafts from older donors had an inferior ability to regenerate 21, 22. The present multivariate analysis, however, failed to support the theoretical background of the age limitation.…”

Section: Discussioncontrasting

confidence: 97%

Volume regeneration after right liver donation

et al. 2004

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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. T he shortage of cadaveric donors has led to an increase in the practice of living donor liver transplantation (LDLT). 1 A vital issue in LDLT is the preservation of a satisfactory blood supply and venous return in both the right and left livers to maximize donor safety and graft function. When splitting the liver along the main portal fissure to harvest a hemiliver graft, however, it is impossible to maintain complete venous outflow in both of the bisected livers, because the middle hepatic vein (MHV) can be preserved on only one side.An extended right liver graft, 2 which includes the MHV trunk, was devised by the Hong Kong group. This method is beneficial with regard to venous drainage of the graft. On the donor side, however, the venous outflow disturbances in segment IV are a concern, and they might disrupt the function of the relevant hepatic region. 3 Consequently, this type of graft is less commonly used than a right liver graft without the MHV trunk. 4 In our institution, we adopted right hepatectomy with or without MHV as the donor procedures for LDLT in selected donor-recipient combinations. The aim of the present study is to clarify whether deprivation of the MHV truly causes adverse effects in donors, including disturbances in liver regeneration of segment IV or functional recovery. Materials and Methods SubjectsFrom March 2000 through March 2003, 138 consecutive living donors underwent hepatectomy...

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Section: Discussioncontrasting

confidence: 97%

Volume regeneration after right liver donation

et al. 2004

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“…We believe that bleeding involved an anastomosis, such as Roux-n-Y, and the low level of platelets, elongation of international normalized ratio, heparin administration by intravenously, and peptic ulcer, and erosive gastritis. Small grafts may cause transient PHT, which increases the risk of gastrointestinal bleeding 14,15 ; however, in our study, we did not have small grafts. Bleeding from a Rouxen-Y anastomosis during the first 2 weeks has been attributed to incomplete hemostasis of the mucosa at the site of the Roux-en-Y anastomosis, facilitated by the reabsorption of the sutures, poor nutritional status, presence of PHT, and use of immunosuppressants.…”

Section: Discussionmentioning

confidence: 72%

Untitled

2014

Exp Clin Transplant

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“…All except the Sheung Tat Fan and Chengdu formulae were used to estimate LV from CT LV or autopsy LV. Estimates of LV by CT were 5%-25% higher than the ALV [30] . Statistical analysis showed that the Fan formula tends to underestimate LV.…”

Section: Discussionmentioning

confidence: 78%

Evaluation of standard liver volume formulae for Chinese adults

Shi

Yan²,

Li³

et al. 2009

WJG

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AIM:To evaluate different standard liver volume (SLV) formula and verify the applicability of the formulae for Chinese adults. METHODS:Data from 70 cases of living donor liver transplantation (LDLT) performed at our transplantation centers between January 2008 and April 2009 were analyzed. SLV was estimated using our recently reported formula [the Chengdu formula: SLV (mL) = 11.5 × body weight (kg) + 334] and other reported formulae used for Chinese adults. Actual intraoperative liver volumes were obtained from a review of the patients' medical records. RESULTS:The actual right liver volume was not significantly different from the estimated right liver volume determined by the Chengdu formula, but was significantly smaller than estimates using the Heinemann, Urata, Vauthey, and Lee formulae (P < 0.01), and significantly larger than estimates using the Fan formula (P < 0.05). CONCLUSION:The Chengdu formula was demonstrated to be reliable by its application in LDLT.

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The influence of donor age to graft volume increase rate in living donor liver transplantation

Cited by 15 publications

References 2 publications

Volume regeneration after right liver donation

Volume regeneration after right liver donation

Untitled

Evaluation of standard liver volume formulae for Chinese adults

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