The Changes of the Medial Right Lobe, Transplanted With Left Lobe Liver Graft From Living Donors
The Changes of the Medial Right Lobe, Transplanted With Left Lobe Liver Graft From Living Donors
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DOI：
10.1097/tp.0b013e318195c2a3
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发表时间：
2009-03-15
期刊：
影响因子：
6.2
通讯作者：
Maehara, Yoshihiko
中科院分区：
文献类型：
--
作者：
Ikegami, Toru;Shimada, Mitsuo;Maehara, Yoshihiko
背景。左肺叶（LL）活体移植与右肺叶内侧（mRL）可能是一种创新技术。从活体供体获得移植物，暴露右侧前Glissonean椎弓根，通过测试夹紧右侧Glissonean椎弓根确认分界线。基于连续计算机断层扫描，评估添加mRL后移植物体积（GV）的增加和体积的变化。添加mRL （n = 7）使GV增加48 +/- 9 g，相当于GV与标准肝脏体积比增加4%。移植后，所有病例的mRL体积均增加。移植后1个月mRL和其他LL段的再生率分别为61% +/- 18%和146% +/- 15%。所有病例均可在移植mri上观察到可存活的肝实质及胆管边缘扩张。在移植mri再生促进的病例中观察到边缘增强。mri头颅部分，所有病例均可见左门静脉分支过肝中静脉。该技术在活体供体LL获取中提供了所有GV的增加，并且应该增加LL移植在活体供体肝移植中的应用。
Background. Procurement of left lobe (LL) living donor graft with medial right lobe (mRL) might be an innovative technique.Methods. The grafts were procured from a living donor, exposing the right anterior Glissonean pedicles, after confirmation of the demarcation line by test-clamping of the right Glissonean pedicle. Based on serial computed tomography, the increase in the graft volume (GV) after addition of mRL and changes in volumes were evaluated.Results. The addition of mRL (n = 7) increased GV by 48 +/- 9 g, which corresponded to a 4% increase in GV-to-standard liver volume ratio. After transplantation, mRL volume has increased in all cases. The regeneration rate of the mRL and other LL segments 1 month after transplantation was 61% +/- 18% and 146% +/- 15%, respectively. Viable hepatic parenchyma with marginal bile duct dilatations in transplanted mRL was observed in all the cases. Marginal enhancement was observed in those cases with promoted regeneration of transplanted mRL. In the cranial part of the mRL, portal branching from the left portal vein, over the middle hepatic vein, was observed in all cases.Conclusion. This technique affords all increase in GV in living donor LL procurement, and should increases the application of LL grafts in living donor liver transplantation.