Reconstruction of hepatic venous tributary in right liver living donor liver transplantation: The importance of the inferior right hepatic vein
Reconstruction of hepatic venous tributary in right liver living donor liver transplantation: The importance of the inferior right hepatic vein
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DOI：
10.1002/lt.24386
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发表时间：
2016-04-01
影响因子：
4.6
通讯作者：
Kokudo, Norihiro
中科院分区：
文献类型：
--
作者：
Ito, Kyoji;Akamatsu, Nobuhisa;Kokudo, Norihiro
在右半肝活体供肝移植(LDLT)中，肝静脉重建必须特别注意，以避免流出道梗阻。我们用冷冻保存的同种异体静脉重建了肝右静脉(RHV)、肝中静脉(MHV)、肝中静脉分支(V5和V8)和肝右下静脉(IRHV)。V5、V8和IRHV的重建是基于通过计算机断层扫描体积测量计算的充血体积，以确保功能性移植物体积为受者标准肝脏体积的40%。在262例右肝LDLT受者中，重建的RHV、MHV、V5、V8和IRHV分别为262、48、110、111和147个，总通畅率分别为95%、100%、36%、58%和86%。尽管RHV和MHV的通畅性令人满意，但V5、V8和IRHV的通畅性不佳。IRHs的通畅率(86%，126/147)明显高于V5(36%，40/110)和V8(58%，/111；P
Special care must be taken in hepatic vein reconstruction to avoid outflow block in living donor liver transplantation (LDLT) with a right liver graft. We have used cryopreserved homologous veins to reconstruct the right hepatic vein (RHV), middle hepatic vein (MHV), MHV tributaries (V5 and V8), and inferior right hepatic vein (IRHV). The reconstruction of V5, V8, and IRHV was based on the estimated congestive volume, calculated by the computed tomography volumetry, to secure the functional graft volume of 40% of the recipient standard liver volume. Among 262 right liver LDLT recipients, the number of reconstructed RHVs, MHVs, V5s, V8s, and IRHVs was 262, 48, 110, 111, and 147, respectively, and the overall patency was 95%, 100%, 36%, 58%, and 86%, respectively. Although the patency of the RHVs and MHVs was satisfactory, that of the V5s, V8s, and IRHVs was suboptimal. Patency of the IRHVs (86%, 126/147) was significantly better than that of both V5s (36%, 40/110) and V8s (58%, 64/111; P