Tailoring transection of segment V vein for optimal sharing of middle hepatic vein in right-lobe living donor liver transplantation

Shin Hwang, Sung Gyu Lee, Tae Yong Ha, Gi Won Song, Dong Sik Kim, Jae Pil Jung, Chul Soo Ahn, Ki Hun Kim, Deok Bog Moon

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background/Aims: Separate reconstruction of multiple V5s (segment V hepatic vein) often resulted in incomplete resolution of hepatic venous congestion (HVC) in the right lobe (RL) grafts. This study intended to obtain single large V5 orifice suitable for middle hepatic vein (MHV) reconstruction. Methodology: We tried tailoring V5 transection in 3 of 39 RL donors, in whom MHV anatomy would reveal multiple sizable V5 orifices along the classical transection plane. During transection of its ventral half, the liver cut surface was intentionally deviated leftward to obtain single large V5 orifice with small sacrifice of the medial segment. Results: Single V5 and single segment VIII vein were reconstructed with interposition vessel graft. Its final shape resembled the combination of RL graft with MHV trunk at the ventral half and RL graft with MHV reconstruction at the dorsal half. There was no noticeable perfusion defect on follow-up computed tomography of all donor and recipient livers. Conclusions: We think that this combination of tailoring V5 transection and interposition graft is fully suggestive of the feasibility of modified extended RL graft in donor livers with variant peripheral MHV branching.

Original languageEnglish
Pages (from-to)904-908
Number of pages5
JournalHepato-gastroenterology
Volume53
Issue number72
Publication statusPublished - 2006 Nov

Keywords

  • Extended right lobe graft
  • Hepatic venous congestion
  • Middle hepatic vein
  • Modified right lobe graft

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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    Hwang, S., Lee, S. G., Ha, T. Y., Song, G. W., Kim, D. S., Jung, J. P., Ahn, C. S., Kim, K. H., & Moon, D. B. (2006). Tailoring transection of segment V vein for optimal sharing of middle hepatic vein in right-lobe living donor liver transplantation. Hepato-gastroenterology, 53(72), 904-908.