Hilar anatomical variations in living-donor liver transplantation using right-lobe grafts.

Abstract:

BACKGROUND:Living-donor liver transplantation using a right-lobe graft has increased the frequency of hilar anatomical variations despite its advantage of a larger graft volume. METHODS:Sixty-seven living-donor liver transplantations using right-lobe grafts are reviewed, regarding the surgical anatomy of hilar vascular and biliary systems. RESULTS:The portal anatomy was classified into four types. The incidence of double portal vein was 6.0% (n = 4), and for such cases a unified orifice (n = 1) or a Y-graft (n = 3) was used for reconstruction. The arterial system was classified into five types. The incidence of arterial complications was 6.0% (n = 4), all of which occurred in cases where the graft artery was connected to the recipient's right hepatic artery. The biliary system was classified into four types. The incidence of a double bile duct was 7.5% (n = 5), and that of a unified one was 29.8% (n = 20). Hepaticojejunostomy was more prone to biliary sepsis (25.0%) and bile leakage (18.8%) than duct-to-duct connection (0 and 2%, respectively). CONCLUSION:Hilar anatomical variations in right-lobe living-donor liver transplantation could be managed after preoperative detailed evaluation of the graft and intraoperative appropriate surgical decision and techniques.

journal_name

Dig Surg

journal_title

Digestive surgery

authors

Ikegami T,Soejima Y,Taketomi A,Yoshizumi T,Harada N,Kayashima H,Itoh S,Yamashita Y,Maehara Y

doi

10.1159/000121907

subject

Has Abstract

pub_date

2008-01-01 00:00:00

pages

117-23

issue

2

eissn

0253-4886

issn

1421-9883

pii

000121907

journal_volume

25

pub_type

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