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Dual-Graft Liver Transplantation

  • Sung-Gyu LeeEmail author
  • Deok-Bog Moon
Chapter
Part of the Springer Surgery Atlas Series book series (SPRISURGERY)

Abstract

Donor safety and small-for-size liver graft (SFSG) have been two critical issues in adult living donor liver transplantation (LDLT). In order to expand adult LDLT and overcome SFSG, right-lobe (RL) grafts have been utilized widely. However, the risk to the donor increases with the extent of donor hepatectomy. In potential donors demonstrating RL to left lobe (LL) volume disproportion, such as those with a RL greater than 70% of the total liver volume on preoperative volumetric CT scans, donation of the RL should be contraindicated for donor safety. Dual LL or left-lateral segment (LLS) transplantation is an alternative option to avoid both SFSG by an LL graft transplantation alone and the higher donor risks associated with a right lobectomy.

Keywords

Dual left-lobe liver transplantation Dual right- and left-lobe liver transplantation 

Notes

Acknowledgments

We sincerely thank our colleagues Dr. JM Namgoong, Dr. CS Ahn, Dr. GW Song, Dr. TY Ha, DH Jung, Dr. KH Kim, Dr. S Hwang, Dr. GC Park, Dr. HW Park, and Dr. YH Park for their contributions and dedication to establish dual living donor liver transplantation as a practical alternative treatment modality for our end-stage liver disease patients.

Further Reading

  1. Lee SG, Hwang S, Park KM, Kim KH, Ahn CS, Lee YJ, et al. Seventeen adult-to-adult living donor liver transplantations using dual grafts. Transplant Proc. 2001;33:3461–3.CrossRefGoogle Scholar
  2. Lee S, Hwang S, Park K, Lee Y, Choi D, Ahn C, et al. An adult-to-adult living donor liver transplant using dual left lobe grafts. Surgery. 2001;129:647–50.CrossRefGoogle Scholar
  3. Moon DB, Lee SG, Hwang S, Kim KH, Ahn CS, Song GW, et al. Resolution of severe graft steatosis following dual-graft living donor liver transplantation. Liver Transpl. 2006;12:1156–60.CrossRefGoogle Scholar
  4. Moon DB, Lee SG, Hwang S, Song GW, Kim KH, Ahn CS, et al. Umbilical portion of recipient’s left portal vein: a useful vascular conduit in dual living donor liver transplantation for the thrombosed portal vein. Liver Transpl. 2004;10:802–6.CrossRefGoogle Scholar
  5. Soejima Y, Taketomi A, Ikegami T, Yoshizumi T, Uchiyama H, Yamashita Y, et al. Living donor liver transplantation using dual grafts from two donors: a feasible option to overcome small-for-size graft problems? Am J Transplant. 2008;8:887–92.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Hepato-Biliary Surgery and Liver Transplantation, Asan Medical CenterUlsan University Medical SchoolSeoulRepublic of Korea
  2. 2.Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea

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