Abstract
The major limitation of adult-adult living donor liver transplantation (A-A LDLT) is graft size insufficiency. Frequently, a left lobe graft from a small donor cannot meet the metabolic demands of a larger recipient. To overcome this limitation many institutes have performed LDLT using a right lobe graft with varying results. However, right lobe graft with no middle hepatic vein (MHV) trunk might be complicated by severe congestion of the anterior segment. The need for MHV reconstruction when using a right lobe graft has not yet been clearly described in the literature. We have had experience with anterior segment congestion of a right liver lobe graft. Our first five right lobe grafts without an MHV trunk were transplanted to two patients with hepatitis B virus (HBV) cirrhosis, two with fulminant hepatic failure, and one with secondary biliary cirrhosis. The right liver grafts weighed 650–1000 g, which corresponded to 48%–83% of the recipient’s standard liver volume. All accessory right hepatic veins (middle and inferior right hepatic veins) were anastomosed to the side of the recipient’s vena cava. Immediately after portal reperfusion, extremely severe congestion and dusky discoloration of the anterior segment developed in two patients followed by prolonged massive ascites and severe liver dysfunction. One of the patients died of sepsis with progressive hepatic dysfunction 20 days after transplantation.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2002 Springer Japan
About this paper
Cite this paper
Lee, S.G. (2002). Middle Hepatic Vein Reconstruction in Living-Donor Liver Transplantation Using the Right Lobe. In: Kitajima, M., Shimazu, M., Wakabayashi, G., Hoshino, K., Tanabe, M., Kawachi, S. (eds) Current Issues in Liver and Small Bowel Transplantation. Keio University International Symposia for Life Sciences and Medicine, vol 9. Springer, Tokyo. https://doi.org/10.1007/978-4-431-67889-2_7
Download citation
DOI: https://doi.org/10.1007/978-4-431-67889-2_7
Publisher Name: Springer, Tokyo
Print ISBN: 978-4-431-68005-5
Online ISBN: 978-4-431-67889-2
eBook Packages: Springer Book Archive