Relationship between preoperative volume and weight of the right liver lobe graft, with and without the middle hepatic vein, in living-donor transplantation.

BACKGROUND: The aim of this study was to assess the relationship between the preoperative volume of the right liver lobe (as determined by computed tomography) and the intraoperative graft weight with or without the middle hepatic vein. METHODS: Sixty-three patients who underwent liver transplantation were included in this study. The preoperative volumes of both the left and the right liver lobe were measured in all patients using computed tomography. The intraoperative weight of the right liver lobe was also measured with (group 1, n = 29) and without (group 2, n = 34) the middle hepatic vein. The results were compared with respect to gender, age, body weight, height, body mass index (BMI), weights of the left and right liver lobes as measured by computed tomography, and intraoperative weight of the right liver lobe. RESULTS: A 21.64 % difference was observed between the weight of the right liver lobe as measured by computed tomography and the weight of the right lobe without the hepatic vein as measured intraoperatively (group 2). Moreover, a 12.38 % difference was observed between the weight of the right liver lobe as measured by computed tomography and the weight of the right lobe plus the middle hepatic vein as measured intraoperatively (group 1). CONCLUSIONS: The weight of the right liver lobe graft in a living-donor transplantation is less than that calculated by preoperative computed tomography, and the inclusion of the middle hepatic vein in the right liver lobe graft resulted in a statistically significant decrease in this difference.

Living donor right liver lobe transplantation with or without inclusion of the middle hepatic vein: analysis of complications.

BACKGROUND: For living-related liver transplantation, harvesting a right hepatic graft that includes the middle hepatic vein (MHV) has been recommended to improve venous drainage of the graft. However, it may result in congestion of the donor's remaining segment IV, increasing the potential risk to the donor. This study aimed to compare safety levels for liver donors during procedures with or without removal of the MHV. METHODS: A total of 68 living donor liver transplantations were performed from March 2001 to May 2007. In 39 procedures, the MHV was not included in the graft (group A), and in 29 the MHV was included in the graft (group B). The analyzed data included surgical time, use of blood derivatives, length of hospital stay, laboratory analyses, weight of the graft, and clinical complications. RESULTS: No differences were observed regarding the need for blood derivatives or laboratory parameters. The frequency of postoperative complications was similar in the two groups, with 10 cases (25.6%) in group A and 7 cases (24.1%) in group B (P=0.887). No deaths were seen. The rate of observed complications was 25% among living donors, most of them being managed without surgical intervention. CONCLUSIONS: The inclusion of the MHV does not add morbidity in living donors in selected cases.