Impact of venous drainage on regeneration of the anterior segment of right living‐related liver grafts
Impact of venous drainage on regeneration of the anterior segment of right living‐related liver grafts
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DOI：
10.1111/j.1399-0012.2006.00515.x
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发表时间：
2006-07
影响因子：
2.1
通讯作者：
S. Mizuno;T. Iida;S. Yagi;M. Usui;H. Sakurai;S. Isaji;S. Uemoto
中科院分区：
文献类型：
--
作者：
S. Mizuno;T. Iida;S. Yagi;M. Usui;H. Sakurai;S. Isaji;S. Uemoto
摘要：根据移植物类型，在三组中比较了额外静脉重建对右叶肝移植物前段形态和功能再生的影响：无肝中静脉（MHV）或MHV分支的右肝移植物（n = 7），有MHV分支的右肝移植物（n = 25）和有MHV的右肝移植物（n = 10）。根据CT扫描和术后实验室数据估计整个移植物体积（GV）和眼前节体积（ASV），并检查每日腹水量。术后2 ~ 3 wk各组均达到GV峰值。有MHV或MHV分支的移植物的ASV/GV比高于没有额外静脉重建的移植物。然而，在同一时期，接受带有MHV支流的移植物的组中的丙氨酸氨基转移酶和腹水量值高于接受带有MHV的移植物的组。尽管术后早期出现了带有MHV支流的右叶移植物前段的快速扩大，但即使在额外的支流重建后，也可能不会发生完全的功能性肝再生。这些结果表明，选择带有MHV的右叶移植物对受体更有利，只要保护供体安全，并且应在不带MHV的右叶移植物中重建尽可能多的MHV分支。
Abstract: The effect of additional venous reconstruction on morphologic and functional regeneration of the anterior segment of right‐lobe liver grafts was compared among three groups according to graft type: right liver graft without the middle hepatic vein (MHV) or MHV tributaries (n = 7), with MHV tributaries (n = 25) and with the MHV (n = 10). Whole graft volume (GV) and anterior segment volume (ASV) were estimated from CT scans and post‐operative laboratory data and daily ascitic fluid volume were examined. Peak GV in each group was reached two or three wk after surgery. The ASV/GV ratios of the grafts with the MHV or MHV tributaries were higher than those of grafts without additional venous reconstruction. However, the asparate aminotransferase and ascitic fluid volume values in the group that received grafts with MHV tributaries were higher than in the group that received grafts with the MHV in the same period. Although rapid enlargement of the anterior segment of right‐lobe grafts with MHV tributaries occurred in the early post‐operative period, complete functional liver regeneration may not occur even after additional tributary reconstruction. These results suggest that the selection of right‐lobe grafts with the MHV is more beneficial for recipients, as long as donor safety is protected and that as many MHV tributaries as possible should be reconstructed in right‐lobe grafts without MHV.