Living-Donor Liver Transplantation Using Left-Liver Graft and Hepatic Vein Reconstruction

Summary

Several new methods have been developed to make living-donor liver transplantation safer. We describe our techniques in hepatic vein reconstruction. Taking the left liver with a caudate lobe graft is useful to overcome the problems of a small graft. Hepatic vein reconstruction appears necessary to allow proportional regeneration of the caudate lobe. A right-liver graft without a middle hepatic vein trunk is another option in this situation. Unless intrahepatic venous communication can be seen in the right-liver, the reconstruction of middle hepatic vein tributaries is essential to prevent congestion of the right paramedian sector.