The effect of living donor liver transplantation with middle hepatic vein or not on the early stage recovery of the donor / 中华肝胆外科杂志

ABSTRACT

Objective To invastigate the effect of living donor liver transplantation(LDLT) with middle hepatic vein(MHV) and LDLT without MHV on the donor. Methods Between August 2007and August 2008, 62 LDLT were performed, 30 LDLT with MHV (group A), 32 LDLT without MHV (group B). Before operation, comprehensive assessment the graft size, remnant liver volume (RLV), fatty liver, MHV type, and the level of portal hypertension in recipient to determine whether harvested MHV. The graft was harvested depending on the port vein and hepatic artery ischemia-line,ultrasound was used to definite the branch of MHV. The donor operative time, intraoperative blood loss, postoperative hospital stay, bilirubin, INR, ALT, albumin, and complications were recorded in detail. Results Operative time, blood loss, hospital stay between group A and group B were not significant difference. But the bilirubin, INR, ALT in group A was higher than group B; Albumin recovered slower and with more ascites in group A. The early complications post-operation were similar in the two groups. There were 2 cases with wound infection in group A and 3 in group B. 3 cases complicated with cholestasis in group A and 1 case in group B, all of them gradually recovered to normal after 2 weeks. 2 cases occurred cross-section bile leakage in either group, the patients administrated with anti-infection, external drainage and recovered;4-7 days after operation, there were 6 cases in group A and 5 cases in group B occurred delayed gastric emptying, it was alleviated after adjust diet, encouraging activities and administrated with gastrointestinal motility drugs. Conclusion Right graft with the middle hepatic vein may lead donor recovery delayed, but with precise evaluation, especially MHV type, remnant liver volume (RLV%)＞30%, preserve the drainage of V4b and the artery segment Ⅳ,it's can ensure the donor's safety.