6. The effectiveness of the functioning of reconstructed hepatic veins using various types of materials in transplantation of the right lobe of the liver from a living donor
DOI:
https://doi.org/10.35805/BSK2024III006Жүктеулер
Аңдатпа
Background. In adult living donor liver transplantation with the right lobe, the venous outflow of the anterior sector is typically restored during the procedure to form a neo-middle hepatic vein. Restoring the middle hepatic vein for the drainage of the anterior sector is critically important for achieving optimal graft function. Various conduits are used for this reconstruction, such as synthetic and biological grafts (e.g., the recipient's portal vein, vessels from a deceased donor, and modified great saphenous vein). However, the selection of the best option remains a topic of discussion. This study evaluates the effectiveness of using biological and synthetic grafts for MHV reconstruction.
Materials and methods. A retrospective analysis of outcomes was conducted in patients who underwent transplantation of a modified right liver lobe due to end-stage liver disease from 2011 to 2024.
Results. A transplantation of modified right liver lobes was performed on 80 patients. In 69 cases, the reconstruction of the hepatic veins was carried out using a biological graft, while in 11 cases, a synthetic graft was used. Statistically significant differences were noted in mortality and the postoperative period. No significant differences were found in the frequency of intraoperative complications.
Conclusion. Our study demonstrates that the use of a biological graft for the reconstruction of the hepatic veins of segments 5 and 8 is more effective than the application of a vascular prosthesis.
Кілт сөздер
Living donor liver transplantation, Hepatic vein, Vascular graft, Venous reconstruction models
Әдебиеттер тізімі
- Yoon YI, Lee SG. Living Donor Liver Transplantation for Hepatocellular Carcinoma: An Asian Perspective. Dig Dis Sci. Apr 2019;64(4):993-1000. doi:10.1007/s10620-019-05551-4
- Balci D, Kirimker EO. Hepatic vein in living donor liver transplantation. Hepatobiliary Pancreat Dis Int. Aug 2020;19(4):318-323. doi:10.1016/j.hbpd.2020.07.002
- Pamecha V, Pattnaik B, Sinha PK, et al. Single Orifice Outflow Re-construction: Refining the Venous Outflow in Modified Right Lobe Live Donor Liver Transplantation. J Gas-trointest Surg. Aug 2021;25(8):1962-1972. doi:10.1007/s11605-020-04776-3
- Kim SH, Kim KH, Cho HD. Donor safety of remnant liver volumes of less than 30% in living donor liver transplantation: A systematic review and meta-analysis. Clin Transplant. Sep 2023;37(9):e15080. doi:10.1111/ctr.15080
- Navarro JG, Choi GH, Kim MS, Jung YB, Lee JG. Right anterior section graft for living-donor liver transplan-tation: A case report. Medicine (Bal-timore). May 2019;98(19):e15212. doi:10.1097/MD.0000000000015212
- Sharma M, Somani P, Rameshba-bu CS, Sunkara T, Rai P. Stepwise evaluation of liver sectors and liver segments by endoscopic ultrasound. World J Gastrointest Endosc. Nov 16 2018;10(11):326-339. doi:10.4253/wjge.v10.i11.326
- Thorat A, Jeng LB, Yang HR, et al. Outflow reconstruction for right liver allograft with multiple hepatic veins: "V-plasty" of hepatic veins to form a common outflow channel versus 2 or more hepatic vein-to-inferior vena cava anastomoses in limited retrohepatic space. Liver Transpl. Feb 2016;22(2):192-200. doi:10.1002/lt.24342
- Chen PX, Yan LN, Wang WT. Outcome of patients undergoing right lobe liv-ing donor liver transplantation with small-for-size grafts. World J Gas-troenterol. Jan 7 2014;20(1):282-9. doi:10.3748/wjg.v20.i1.282
- Guler N, Yaprak O, Gunay Y, et al. Ma-jor complications of adult right lobe living liver donors. Hepatobiliary Pancreat Dis Int. Apr 2015;14(2):150-6. doi:10.1016/s1499-3872(15)60346-0
- Vella I, di Francesco F, Accardo C, Boggi U, Gruttadauria S. Indications and results of right-lobe living donor liver transplantation. Updates Surg. May 27 2024; doi:10.1007/s13304-024-01785-8
- Lee SG. A complete treatment of adult living donor liver transplanta-tion: a review of surgical technique and current challenges to expand in-dication of patients. Am J Transplant. Jan 2015;15(1):17-38. doi:10.1111/ajt.12907
- Morita K, Nishie A, Asayama Y, et al. Congestion Area of the Right Lobe Graft in Living Donor Liver Trans-plantation: Quantitative Evaluation of Hemodynamics Using Comput-ed Tomography Perfusion. Trans-plant Proc. Jun 2021;53(5):1653-1658. doi:10.1016/j.transproceed.2021.02.024
- Hong SY, Kim T, Kim M, Lee HY, Wang HJ, Kim BW. Strategy for Selective Middle Hepatic Vein Re-construction in Living Donor Liver Transplantation Using Right Lobe Graft: A Retrospective Observa-tional Study. Transplant Proc. Sep 2021;53(7):2318-2328. doi:10.1016/j.transproceed.2021.07.042
- Sapisochin G, Goldaracena N, Lau-rence JM, Levy GA, Grant DR, Cattral MS. Right lobe living-donor hepa-tectomy-the Toronto approach, tips and tricks. Hepatobiliary Surg Nutr. Apr 2016;5(2):118-26. doi:10.3978/j.issn.2304-3881.2015.07.03
- Lee SH, Na GH, Choi HJ, Kim DG, You YK. Impact of the Reconstruc-tion Material on the Patency of Middle Hepatic Vein in Living Do-nor Liver Transplantation Using the Right Liver. Transplant Proc. Oct 2019;51(8):2745-2749. doi:10.1016/j.transproceed.2019.03.075
- Miller CM, Quintini C, Dhawan A, et al. The International Liver Transplanta-tion Society Living Donor Liver Trans-plant Recipient Guideline. Trans-plantation. May 2017;101(5):938-944. doi:10.1097/TP.0000000000001571
- Stuben BO, Heumann A, Sturznick-el J, Izbicki JR, Li J. Successful Use of the Recanalized Remnant Um-bilical Vein as a Patch Graft for Ve-nous Reconstruction in Abdominal Surgery. J Gastrointest Surg. Jun 2019;23(6):1227-1231. doi:10.1007/s11605-019-04150-y
- Kim SH, Hwang S, Ha TY, et al. Us-ability of Cryopreserved Aortic Al-lografts for Middle Hepatic Vein Re-construction During Living-Donor Liver Transplantation. J Gastroin-test Surg. May 2016;20(5):1049-55. doi:10.1007/s11605-015-3048-0
- Durairaj MS, Shaji Mathew J, Mal-lick S, et al. Middle hepatic vein reconstruction in adult living do-nor liver transplantation: a ran-domized clinical trial. Br J Surg. Dec 1 2021;108(12):1426-1432. doi:10.1093/bjs/znab346
- Guan Z, Ren X, Xu G, Zang Y, Chen X, Shen Z. [Cryopreserved iliac vein for reconstruction of middle hepatic vein in living donor right liver transplanta-tion]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. Nov 2011;25(11):1393-6
- Arikan T, Mammadov E, Emek E, et al. Utility of Polyethylene Tere-phthalate (Dacron) Vascular Grafts for Venous Outflow Reconstruc-tion in Living-Donor Liver Trans-plantations. Transplant Proc. Sep 2019;51(7):2442-2445. doi:10.1016/j.transproceed.2019.02.040