Strategy for Selective Middle Hepatic Vein Reconstruction in Living Donor Liver Transplantation Using Right Lobe Graft: A Retrospective Observational Study |
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| Affiliation: | 1. Department of Surgery, Catholic Kwandong University College of Medicine, Gangneung, Korea;2. Department of Liver Transplantation and Hepatobiliary Surgery, Ajou University School of Medicine, Suwon, Korea;3. Department of Biostatistics, Clinical Trial Center, Ajou University School of Medicine, Suwon, Korea;1. Department of Public Health Graduate School, Chonnam National University, Gwangju, Republic of Korea;2. Department of Surgery, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea;1. Division of Transplant, Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska;2. Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin;1. Infectious and Tropical Medicine Department, Hospital Center of Cayenne, Cayenne, French Guiana, France;2. Faculté de Médecine, Université de Paris, Paris, France;3. Clinical Investigation Center in Clinical Epidemiology French Guiana « Inserm CIC 1424 », Hospital Center of Cayenne, Cayenne, French Guiana, France;4. EA3593, Epidémiologie des Parasitoses et des Mycoses Tropicales, Medicine University of the West Indies and French Guiana, Cayenne, French Guiana, France;5. Nephrology Department, Hospital Center of Cayenne, Cayenne, French Guiana, France;6. Coordination Régionale de lutte contre le Virus de l''Immunodéficience Humaine, « COREVIH », Hospital Center of Cayenne, French Guiana, France;7. Association pour le Traitement de l''Insuffisance Rénale Guyane « A.T.I.R.G », Cayenne, French Guiana, France |
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| Abstract: | BackgroundThe aim of this study was to verify the safety and feasibility of our selection criteria for middle hepatic vein (MHV) reconstruction in living donor liver transplantation (LDLT) using right lobe grafts.MethodsA total of 153 LDLTs were performed using right lobe grafts in a tertiary hospital from 2006 to 2016. Among them, 52 cases without MHV reconstruction were compared with 101 recipients who underwent LDLT using right lobe graft with MHV reconstruction. Both groups were compared regarding indications for reconstruction, short-term and long-term complications, operative details, and outcomes.ResultsThe two groups differed only in cold ischemic time (108.19 ± 49.81 minutes vs 146.37 ± 58.74 minutes) preoperatively. Short-term posttransplant outcomes, long-term overall survival, and long-term disease-free survival showed no significant differences between the 2 groups. After propensity score matching for both groups with and without MHV reconstruction to eliminate selection bias, the 2 groups were comparable.ConclusionsWe found that our selection criteria for performing MHV reconstruction in LDLT using right lobe graft were feasible and safe. A routine MHV reconstruction is not necessary if the right lobe graft graft-to-recipient weight ratio is ≥1.0, right hepatic vein draining territory volume is ≥0.8, and recipient Model for End-Stage Liver Disease score is <20. |
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