Tailoring the type of donor hepatectomy for adult living donor liver transplantation
Tailoring the type of donor hepatectomy for adult living donor liver transplantation
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DOI：
10.1111/j.1600-6143.2005.00917.x
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发表时间：
2005-07-01
影响因子：
8.8
通讯作者：
Makuuchi, M
中科院分区：
文献类型：
--
作者：
Kokudo, N;Sugawara, Y;Makuuchi, M
对 200 名连续供体进行了成人活体肝移植的供体肝切除术，收获左肝 (LL) 移植物 (n = 5)、LL 加尾状叶 (LL + CL) 移植物 (n = 63)、右肝 (RL) 移植物 (n = 86)、RL 和肝中静脉 (RL + MHV) 移植物 (n = 28) 或右侧段 (RLS) 移植物 (n = 18）。选择移植物类型，以便收获至少 40% 的接受者标准肝脏体积。没有发生捐赠者死亡，并且当根据移植物类型对结果进行分层时，捐赠者或接受者之间的发病率没有显着差异。捐献 RL 的捐献者比捐献非 RL（LL、LL + CL、RLS）移植物的捐献者表现出更高的血清总胆红素和凝血酶原时间值。肺门解剖和实质横断所需的时间按以下顺序增加：RLS 移植物、LL 移植物和 RL 移植物收获。总之，非RL移植耗时较长，但供体肝功能损失较小。我们的移植物选择标准有助于减少供体和受者发病率可接受的 RL 移植物的使用。
Donor hepatectomies for adult living donor liver transplantations were performed in 200 consecutive donors to harvest a left liver (LL) graft (n = 5), a LL plus caudate lobe (LL + CL) graft (n = 63), a right liver (RL) graft (n = 86), a RL and middle hepatic vein (RL + MHV) graft (n = 28) or a right lateral sector (RLS) graft (n = 18). The graft type was selected so that at least 40% of the recipient's standard liver volume was harvested. No donor deaths occurred, and no significant differences in the morbidity rates among either donors or recipients were observed when the outcomes were stratified according to the graft type. Donors who donated RL exhibited higher values of serum total bilirubin and prothrombin time than those who donated non-RL (LL, LL + CL, RLS) grafts. The time taken for hilar dissection and parenchymal transection increased in the following order: RLS graft, LL graft and RL graft harvesting. In conclusion, non-RL grafting was more time consuming, but the hepatic functional loss in the donors was smaller. Our graft selection criteria were useful for reducing the use of RL grafts with acceptable morbidity in both donors and recipients.