| Hypoperfusion of segment 4 in right in situ split-liver transplantation. | |
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MedLine Citation:
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PMID: 20534271 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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To expand the donor pool, split-liver transplantation has been implemented in recent years. In the classic technique, the arterial axis with the artery for segment 4 (S4) coming from the left hepatic artery (HA) is included with the right graft. To give a surgical advantage to pediatric recipients in our center, the left HA, the common HA, and the celiac trunk are generally retained with the left liver. Thus the artery for S4 is sacrificed. We compared the outcomes of S4 in 290 whole grafts (WG; group A) with 28 right in situ split-liver grafts (SSLG; group B), which were transplanted over the past 10 years (January 1999-December 2009). The rates of major biliary and of hemorrhagic complications were similar. In most of cases (16/24, 66%) S4, on computerized tomographic scan appeared to show signs of hypoperfusion, sometimes with a peripheral aspect of hyperperfusion in the arterial phase. S1 showed signs of hypoperfusion in only 2 cases. A biliary collection near the resection line present in 8 cases was treated in 6 of them with percutaneous drainage and in 2 with laparotomy. These complications did not influence graft or patient survival. Graft survivals at 1, 5, and 10 years for WG and SSLG were not different among the groups: 85%, 74%, and 66% vs 89%, 79%, and 63%, respectively (P = .8). Although our technique cannot be considered to be anatomically correct, the ischemia of S4 did not influence the outcome. The rate of retransplantations for hepatic artery thrombosis was 17.9% in RSSG and 3.4% in WG (P = .001), which was probably due at least in part to the insertion of interposition grafts. |
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Authors:
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U Maggi; L Caccamo; P Reggiani; R Lauro; P Bertoli; S Camagni; I M Paterson; G Rossi |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Transplantation proceedings Volume: 42 ISSN: 1873-2623 ISO Abbreviation: Transplant. Proc. Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-06-10 Completed Date: 2010-10-29 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0243532 Medline TA: Transplant Proc Country: United States |
Other Details:
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Languages: eng Pagination: 1240-3 Citation Subset: IM |
Copyright Information:
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Copyright (c) 2010. Published by Elsevier Inc. |
Affiliation:
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Unitá Operativa di Chirurgia Generale e dei Trapianti di Fegato, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena di Milano v Francesco Sforza 35 - 20121, Milano, Italy. u.maggi@tiscali.it |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Female Graft Survival Hepatectomy / methods* Hepatic Artery / pathology, transplantation Humans Intraoperative Complications / epidemiology Liver / anatomy & histology*, blood supply Liver Transplantation / methods, mortality, pathology, physiology* Magnetic Resonance Spectroscopy Male Middle Aged Postoperative Complications / epidemiology Retrospective Studies Survival Rate Survivors Tissue Donors Tomography, X-Ray Computed Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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