Advertisement

Surgery Today

, 41:1266 | Cite as

Three-dimensional computed tomography analysis of venous collaterals between the middle hepatic vein tributaries and the right hepatic vein in the donor remnant right lobe: Report of a case

  • Hiroto Kayashima
  • Ken Shirabe
  • Akinobu Taketomi
  • Yuji Soejima
  • Hideaki Uchiyama
  • Mizuki Ninomiya
  • Nao Kinjo
  • Yoshihiko Maehara
Case Report

Abstract

We report how three-dimensional computed tomography (3D-CT) showed the development of obvious venous collaterals between the middle hepatic vein (MHV) tributaries and the right hepatic vein (RHV) in the remnant right lobe of a donor liver. The donor was a healthy 34-year-old man who donated the left lobe of his liver with the MHV. The 3D-CT calculated that the total drainage of the MHV tributaries was 413 ml, corresponding to 59% of the total remnant liver. The congestion calculated by 3D-CT decreased from 286 ml on postoperative day (POD) 7 to 28 ml on POD 35, corresponding to 36% and 3% of the total remnant liver, respectively. The donor was discharged from hospital with almost normal liver function, and 3D-CT analysis on POD 35 detected obvious venous collaterals between the MHV tributaries and the RHV. These findings suggest that reconstruction of the MHV tributaries in the donor remnant right lobe may not be necessary.

Key words

Living donor liver transplantation Hepatic venous congestion Intrahepatic venous anastomosis Left lobe graft Reconstruction of middle hepatic vein 

References

  1. 1.
    Fukuhara T, Umeda K, Toshima T, Takeishi K, Morita K, Nagata S, et al. Congestion of the donor remnant right liver after extended left lobe donation. Transpl Int 2009;22:837–844.PubMedCrossRefGoogle Scholar
  2. 2.
    Sugimachi K, Toshima T, Taketomi A, Soejima Y, Gion T, Ikegami T, et al. Chronological improvement of portal flow in the remnant right lobe liver of a left lobe living donor. Transplantation 2009;88: 598–600.PubMedCrossRefGoogle Scholar
  3. 3.
    Ikegami T, Soejima Y, Taketomi A, Yoshizumi T, Harada N, Uchiyama H, et al. Explanted portal vein grafts for middle hepatic vein tributaries in living-donor liver transplantation. Transplantation 2007;84:836–841.PubMedCrossRefGoogle Scholar
  4. 4.
    Kayashima H, Taketomi A, Yonemura Y, Ijichi H, Harada N, Yoshizumi T, et al. Accuracy of an age-adjusted formula to assess the graft volume in living donor liver transplantation. Liver Transpl 2008;14:1366–1371.PubMedCrossRefGoogle Scholar
  5. 5.
    Yonemura Y, Taketomi A, Soejima Y, Yoshizumi T, Uchiyama H, Gion T, et al. Validity of preoperative volumetric analysis of congestion volume in living donor liver transplantation using three-dimensional computed tomography. Liver Transpl 2005;11:1556–1562.PubMedCrossRefGoogle Scholar
  6. 6.
    Hashikura Y, Makuuchi M, Kawasaki S, Matsunami H, Ikegami T, Nakazawa Y, et al. Successful living-related partial liver transplantation to an adult patient. Lancet 1994;343:1233–1234.PubMedCrossRefGoogle Scholar
  7. 7.
    Lee SG, Hwang S, Kim KH, Ahn CS, Moon DB, Ha TY, et al. Toward 300 liver transplants a year. Surg Today 2009;39:367–373.PubMedCrossRefGoogle Scholar
  8. 8.
    Miller CM, Gondolesi GE, Florman S, Matsumoto C, Munoz L, Yoshizumi T, et al. One hundred nine living donor liver transplantations in adults and children: a single-center experience. Ann Surg 2001;234:311–312.CrossRefGoogle Scholar
  9. 9.
    Marcos A. Right lobe living donor liver transplantation: a review. Liver Transpl 2000;6:3–20.PubMedGoogle Scholar
  10. 10.
    Umeshita K, Fujiwara K, Kiyosawa K, Makuuchi M, Satomi S, Sugimachi K, et al.; Japanese Liver Transplantation Society. Operative morbidity of living liver donors in Japan. Lancet 2003;362: 687–690.Google Scholar
  11. 11.
    Brown RS Jr, Russo MW, Lai M, Shiffman ML, Richardson MC, Everhart JE, et al. A survey of liver transplantation from living adult donors in the United States. N Engl J Med 2003;348:818–825.PubMedCrossRefGoogle Scholar
  12. 12.
    Soejima Y, Taketomi A, Yoshizumi T, Uchiyama H, Harada N, Ijichi H, et al. Feasibility of left lobe living donor liver transplantation between adults: an 8-year, single-center experience of 107 cases. Am J Transpl 2006;22:1004–1011.CrossRefGoogle Scholar
  13. 13.
    Taketomi A, Kayashima H, Soejima Y, Yoshizumi T, Uchiyama H, Ikegami T, et al. Donor risk in adult-to-adult living donor liver transplantation: impact of left lobe graft. Transplantation 2009;87: 445–450.PubMedCrossRefGoogle Scholar
  14. 14.
    Kaneko T, Sugimoto H, Hirota M, Kure S, Kiuchi T, Nakao A. Intrahepatic venous anastomosis formation of the right liver in living donor liver transplantation: evaluations by Doppler ultrasonography and pulse-inversion ultrasonography with Levovist. Surgery 2005;138:21–27.PubMedCrossRefGoogle Scholar
  15. 15.
    Yan L, Wu H, Chen Z, Luo Y, Lu Q, Zhang Z, et al. Intrahepatic venous collaterals formation following outflow block in adult-toadult living donor liver transplantation. J Surg Res 2008;146: 172–176.PubMedCrossRefGoogle Scholar
  16. 16.
    Soejima Y, Shimada M, Suehiro T, Yoshizumi T, Kishikawa K, Maehara Y. Reconstruction of the middle hepatic vein tributaries using the recipient’s recanalized umbilical vein in right-lobe living-donor liver transplantation. Surgery 2006;139:442–445.PubMedCrossRefGoogle Scholar
  17. 17.
    Troisi R, Cammu G, Militerno G, De Baerdemaeker L, Decruyenaere J, Hoste E, et al. Modulation of portal graft inflow: a necessity in adult living-donor liver transplantation? Ann Surg 2003;237: 429–436.PubMedGoogle Scholar

Copyright information

© Springer 2011

Authors and Affiliations

  • Hiroto Kayashima
    • 1
  • Ken Shirabe
    • 1
  • Akinobu Taketomi
    • 1
  • Yuji Soejima
    • 1
  • Hideaki Uchiyama
    • 1
  • Mizuki Ninomiya
    • 1
  • Nao Kinjo
    • 1
  • Yoshihiko Maehara
    • 1
  1. 1.Department of Surgery and Science, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan

Personalised recommendations