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Conference Paper: Extended right liver graft and outflow reconstruction

TitleExtended right liver graft and outflow reconstruction
Authors
Issue Date2006
PublisherJohn Wiley & Sons
Citation
The 3rd International Conference of Living Donor Abdominal Organ Transplantation: State of the Art, Sardegna, Italy, 23-24 June 2006. In Clinical Transplantation, 2006, v. 20 n. S16, p. 18-19 Abstract no. INV-36 How to Cite?
Abstract‘‘Extended right liver graft’’ was the term we used at the beginningof our right lobe living donor liver transplant (LDLT) programbecause the liver transection line was about 1 cm on the left side ofthe middle hepatic vein (MHV). The inclusion of the liver wasthought to be necessary for protection of the MHV. We subse-quently recognized that inclusion of the liver on the left side of theMHV was not necessary and actually dangerous. It predisposed toinfection on the transection surface. Nowadays, the liver transectionline is exactly on the Cantlie line and the MHV is exposed from thejunction where it receives the segment 4a (distal portion of segment4) hepatic vein to the junction with the left hepatic vein or inferiorvena cava. The major branch of the segment 4b hepatic vein ispreserved with the donor. Such a graft design is now called a rightliver graft containing the MHV. Before implantation, the MHV isjoined to the right hepatic vein to form a triangular orifice. In the recipient, the inferior vena cava is crossclamped and a matched-sizetriangular opening is made for anastomosis with the MHV/righthepatic vein of the graft. The outcome of the anastomosis is assessedby Doppler ultrasonography. A triphasic pulsatility wave form is anindication of successful reconstruction. With this technique, a large,non-redundant, and completely patent hepatic vein anastomosisand, thus, liver function are ensured. The 5-year survival rate forright liver LDLT recipients (82.2%) is comparable to that for whole-graft deceased donor liver transplant recipients (83.7%), whether therecipients suffered from cirrhosis, acute deterioration of cirrhosis,acute on chronic hepatitis B infection, or fulminant hepatic failure.
Persistent Identifierhttp://hdl.handle.net/10722/107194
ISSN
2015 SCImago Journal Rankings: 0.821

 

DC FieldValueLanguage
dc.contributor.authorFan, STen_HK
dc.date.accessioned2010-09-25T23:47:31Z-
dc.date.available2010-09-25T23:47:31Z-
dc.date.issued2006en_HK
dc.identifier.citationThe 3rd International Conference of Living Donor Abdominal Organ Transplantation: State of the Art, Sardegna, Italy, 23-24 June 2006. In Clinical Transplantation, 2006, v. 20 n. S16, p. 18-19 Abstract no. INV-36-
dc.identifier.issn1399-0012-
dc.identifier.urihttp://hdl.handle.net/10722/107194-
dc.description.abstract‘‘Extended right liver graft’’ was the term we used at the beginningof our right lobe living donor liver transplant (LDLT) programbecause the liver transection line was about 1 cm on the left side ofthe middle hepatic vein (MHV). The inclusion of the liver wasthought to be necessary for protection of the MHV. We subse-quently recognized that inclusion of the liver on the left side of theMHV was not necessary and actually dangerous. It predisposed toinfection on the transection surface. Nowadays, the liver transectionline is exactly on the Cantlie line and the MHV is exposed from thejunction where it receives the segment 4a (distal portion of segment4) hepatic vein to the junction with the left hepatic vein or inferiorvena cava. The major branch of the segment 4b hepatic vein ispreserved with the donor. Such a graft design is now called a rightliver graft containing the MHV. Before implantation, the MHV isjoined to the right hepatic vein to form a triangular orifice. In the recipient, the inferior vena cava is crossclamped and a matched-sizetriangular opening is made for anastomosis with the MHV/righthepatic vein of the graft. The outcome of the anastomosis is assessedby Doppler ultrasonography. A triphasic pulsatility wave form is anindication of successful reconstruction. With this technique, a large,non-redundant, and completely patent hepatic vein anastomosisand, thus, liver function are ensured. The 5-year survival rate forright liver LDLT recipients (82.2%) is comparable to that for whole-graft deceased donor liver transplant recipients (83.7%), whether therecipients suffered from cirrhosis, acute deterioration of cirrhosis,acute on chronic hepatitis B infection, or fulminant hepatic failure.-
dc.languageengen_HK
dc.publisherJohn Wiley & Sons-
dc.relation.ispartofClinical Transplantationen_HK
dc.titleExtended right liver graft and outflow reconstructionen_HK
dc.typeConference_Paperen_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1111/j.1399-0012.2006.00577_1.x-
dc.identifier.hkuros117205en_HK
dc.identifier.hkuros135447-

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