Document Detail


Donor/recipient algorithm for management of the middle hepatic vein in right graft live donor liver transplantation.
MedLine Citation:
PMID:  20074699     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The aim of this study was to delineate an algorithm for donor and recipient criteria and middle hepatic vein (MHV) management in right-graft live-donor liver transplantation (LDLT) on the basis of computerized 3-dimensional computed tomographic image analysis. METHODS: Data on 94 consecutive right-graft LDLTs were prospectively collected. Graft and remnant data for the first 23 cases were retrospectively evaluated by means of 3-dimensional computed tomographic reconstructions, and on the basis of that preliminary series, a graft selection algorithm using 3 parameters-hepatic vein dominance classification, graft and remnant graft volume/body weight ratios, and congestion volumes-was created. It was subsequently applied to the next 71 right-graft LDLTs. RESULTS: Fifty-nine right grafts contained the MHV. Four of the 12 grafts with no MHVs required MHV reconstructions. In 18 cases, small liver grafts were used. The postoperative function of liver grafts and remnants with versus without MHVs was not statistically different. CONCLUSIONS: The proposed algorithm favored the inclusion of the MHV with the right grafts. It also allowed for the procurement of grafts that were potentially small for size without compromising donor or recipient safety.
Authors:
A Radtke; G Sgourakis; G C Sotiropoulos; S Beckebaum; E P Molmenti; F H Saner; T Schroeder; S Nadalin; A Schenk; H Lang; M Malag?; C E Broelsch
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-01-15
Journal Detail:
Title:  American journal of surgery     Volume:  199     ISSN:  1879-1883     ISO Abbreviation:  Am. J. Surg.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-14     Completed Date:  2010-06-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370473     Medline TA:  Am J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  708-15     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2010. Published by Elsevier Inc.
Affiliation:
Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany. radtke@ach.klinik.uni-mainz.de
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MeSH Terms
Descriptor/Qualifier:
Algorithms*
Analysis of Variance
Cohort Studies
Female
Follow-Up Studies
Graft Rejection
Graft Survival
Hepatectomy / adverse effects,  methods
Hepatic Veins / surgery,  transplantation*
Humans
Imaging, Three-Dimensional
Liver / anatomy & histology,  blood supply*,  radiography,  surgery
Liver Circulation
Liver Transplantation / adverse effects,  methods*
Living Donors*
Male
Patient Selection
Postoperative Complications / epidemiology,  physiopathology
Preoperative Care / methods
Prospective Studies
Risk Assessment
Tissue and Organ Procurement
Tomography, X-Ray Computed
Treatment Outcome

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


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