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Clinical application of arterialization of portal vein in living related donor partial liver transplantation

  • Original Articles
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Transplant International

Abstract

Arterialization of the portal vein was employed during hepatic arterial reconstruction in our first few clinical experiences of partial liver transplantation using liver grafts obtained from living related donors. This procedure reduced the time required for revascularization of the grafts to about 25 min, and could in fact reduce the ischemic phase of the grafts. Repeated practice of the clinical transplantation technique has shortened the time needed to complete vascular reconstruction, eliminating the need for this procedure in most of our subsequent cases. In many clinical cases, however, there may be emergency situations which require vascular reconstruction, resulting in a prolongation of ischemic phase and the deterioration of the cellular viability of the graft. In such situations, arterialization of the portal vein can be a useful way to prevent the prolongation of the ischemic phase and to rescue the graft.

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References

  1. Asonuma K, Takaya S, Selby R, Okamoto R, Yamamoto Y, Yokoyama T, Todo S, Ozawa K, Starzl TE (1991) The clinical significance of the arterial ketone body ratio as an early indicator of graft viability in human liver transplantation. Transplantation 51: 164–171

    Google Scholar 

  2. Broelsch CE, Emond JC, Whitington PF, Thistlethwaite JR, Baker AL, Lichtor JL (1990) Application of reduced-sized liver transplantation as split grafts, auxiliary orthotopic grafts, and living related segmental transplants. Ann Surg 212: 368–375

    Google Scholar 

  3. Higashiyama H, Sasaki H, Kumada H, Egawa H, Yamamoto N, Takeuchi T, Konishi Y, Yamaguchi M, Okamoto R, Yamaguchi T, Yamaoka Y, Tanaka K, Ozawa K (1991) Temporary portal vein arterialization as an attractive option in canine orthotopic partial liver transplantation. Eur Surg Res 23: 185–194

    Google Scholar 

  4. Morimoto T, Ukikusa M, Taki Y, Koizumi K, Yokoo N, Tanaka A, Noguchi M, Yamamoto S, Nitta N, Kamiyama Y, Yamaoka Y, Ozawa K (1988) Changes in energy metabolism of allografts after liver transplantation. Eur Surg Res 20: 120–127

    Google Scholar 

  5. Ozaki N, Ringe B, Bunzendahl H, Taki Y, Gubernatis G, Oellerich M, Kuse ER, Kiuchi T, Yamauchi K, Takada Y, Yamaguchi T, Ozawa K, Pichlmayr R (1991) Ketone body ratio as an indicator of early graft survival in clinical liver transplantation. Clin Transplant 5: 48–54

    Google Scholar 

  6. Sheil AGR, Thompson JF, Stephen MS, Eyers AA, Bookallil M, McCaughan GW, Dorney SFA, Bell R, Mears D, Kelly GE, Woodman K (1989) Donor portal vein arterialization during liver transplantation. Transplant Proc 21: 2343–2344

    Google Scholar 

  7. Strong RW, Lynch SV, Ong TH, Matsunami H, Kaido Y, Balderson GA (1990) Successful liver transplantation from a living donor to her son. N Engl J Med 322: 1505–1507

    Google Scholar 

  8. Taki Y, Ukikusa M, Morimoto T, Yokoo N, Koizumi K, Noguchi M, Tanaka A, Yamamoto S, Nitta N, Kamiyama Y, Shimahara Y, Yamaoka Y, Ozawa K (1987) Short-term changes in blood ketone body ratio in the phase immediately after liver transplantation. Transplantation 43: 350–353

    Google Scholar 

  9. Taki Y, Gubernatis G, Yamaoka Y, Oellerich M, Yamamoto Y, Ringe B, Okamoto R, Bunzendahl H, Beneking M, Burdelski M, Bornscheuer A, Pichlmayr R (1990) Significance of arterial ketone body ratio measurement in human liver transplantation. Transplantation 49: 535–539

    Google Scholar 

  10. Tanaka K, Tokunaga Y, Zaima M, Sakai Y, Yamamoto Y, Ueda J, Takada Y, Yamaguchi M, Katayama T, Kitakado Y, Yamaoka Y, Ozawa K (1988) Graft transection and warm perfusion in situ in canine partial orthotopic liver transplantation. Transplant Int 1: 213–218

    Google Scholar 

  11. Tokunaga Y, Zaima M, Tanaka K, Maki A, Katayama T, Sakai Y, Egawa H, Kiuchi T, Yamamoto Y, Ueda J, Lin H, Kitakado Y, Nitta N, Kamiyama Y, Yamaoka Y, Ozawa K (1989) Orthotopic partial liver transplantation on dogs can be performed without cold perfusion of the donor liver. Eur Surg Res 21: 137–144

    Google Scholar 

  12. Uno T, Itoh M, Kurono Y, Yamaoka Y, Kamiyama Y, Ozawa K (1987) A simple and sensitive assay for blood ketone bodies using highly purified 3-hydroxybutyrate dehydrogenase. Clin Chim Acta 168: 253–255

    Google Scholar 

  13. Yamaguchi M, Higashiyama H, Kumada K, Okamoto R, Shimahara Y, Ozawa K (1989) Evaluation of portal vein arterialization as a method of liver graft revascularization by blood ketone body ratio. Transplantation 48: 514–516

    Google Scholar 

  14. Yamaguchi M, Higashiyama H, Kumada K, Okamoto R, Ueda J, Shimahara Y, Ozawa K (1990) Evaluation of temporary portal vein arterialization: the minimum arterialized blood flow for maintaining liver viability. Transplant Int 3: 162–166

    Google Scholar 

  15. Zaima M, Tokunaga Y, Tanaka K, Yamamoto Y, Sakai Y, Ueda J, Okamoto R, Iaki I, Wakashiro S, Wada Y, Kimoto M, Okanoue T, Mori K, Yamaoka Y, Ozawa K (1989) Canine orthotopic partial liver transplantation using grafts procured in situ. Surg Res Comm 5: 229–237

    Google Scholar 

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Morimoto, T., Terasaki, M., Higashiyama, H. et al. Clinical application of arterialization of portal vein in living related donor partial liver transplantation. Transplant Int 5, 151–154 (1992). https://doi.org/10.1007/BF00336600

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  • DOI: https://doi.org/10.1007/BF00336600

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