Modified Right-Lobe Graft
The inadequacy of the graft size was a major limitation for adult living-donor liver transplantation (LDLT). The development of right-lobe graft LDLT was a solution to this problem and increased the transplantation options for many patients. The small-for-size graft syndrome may still occur, however, even with transplantation of a larger right-lobe graft, without middle hepatic vein (MHV) drainage. Although the graft size is critical for the successful outcome of adult LDLT, uniformly good venous drainage of the anterior sector of the right hemiliver graft is important for maximizing the functioning liver graft mass. A good hepatic venous outflow is essential for both function and regeneration of the partial liver graft.
KeywordsModified right-lobe graft Middle hepatic vein
I sincerely thank my colleagues, Dr. DB Moon, Dr. S Hwang, Dr. KH Kim, Dr. CS Ahn, Dr. GW Song, Dr. TY Ha, Dr. DH Jung, Dr. GC Park, Dr. HY Park, and Dr. YH Park, for their enormous efforts and dedication in refining the modified right-lobe LDLT to be accepted as the standard procedure for right-lobe partial liver transplantation. I particularly appreciate the contributions of Dr. JM Namgoong and Dr. BH Chung in making the illustrations and photos in this chapter.
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