Document Detail


Intraoperative assessment of hepatic venous congestion with direct clamping of the hepatic vein trunk for living donor liver transplantation.
MedLine Citation:
PMID:  15251358     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We devised a hepatic vein clamping method to assess the amount of hepatic venous congestion (HVC) before liver transection. From February 2003 to May 2003, this method was applied to 5 of 58 living donor livers especially to assess donor safety. The left portal vein and proper hepatic artery as well as the middle hepatic vein (MHV)-left hepatic vein (LHV) trunk were clamped simultaneously to assess the HVC in the remnant right lobe before performing extended left lobectomy. As three donors demonstrated the extent of the HVC equivalent to about 40% of the right lobe volume (RLV), their operations proceeded according to the preoperative plan. The territory of HVC after liver transection was the same as that observed with direct clamping of the hepatic vein. However, one donor showed massive HVC more than 50% of RLV and the operative plan was adjusted to harvest only the left lobe without the MHV trunk for donor safety. To assess the HVC in the remnant left lobe, the isolated LHV trunk was occluded after clamping the donor's proper hepatic artery. The whole left lobe except for a small area at the anterior portion of the medial segment became discolored on LHV clamping: the opposite demarcation appeared on MHV clamping. The amount of HVC was so small that we harvested the right lobe with the MHV trunk. All donors and recipients recovered uneventfully. We believe that this direct clamping method makes the assessment of HVC feasible before parenchymal transection of a donor liver.
Authors:
S Hwang; S G Lee; K H Kim; K M Park; Y J Lee; C S Ahn; D B Moon; T Y Ha; S H Cho; K B Oh
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Transplantation proceedings     Volume:  36     ISSN:  0041-1345     ISO Abbreviation:  Transplant. Proc.     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-07-14     Completed Date:  2005-03-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0243532     Medline TA:  Transplant Proc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1462-5     Citation Subset:  IM    
Copyright Information:
Copyright 2004 Elsevier Inc.
Affiliation:
Division of Hepatopancreatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, South Korea.
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MeSH Terms
Descriptor/Qualifier:
Adult
Hepatectomy / methods*
Hepatic Artery / surgery
Hepatic Veins / surgery*
Humans
Monitoring, Intraoperative / methods
Retrospective Studies
Tissue and Organ Harvesting / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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