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Article: Hepatic venoplasty in right lobe live donor liver transplantation

TitleHepatic venoplasty in right lobe live donor liver transplantation
Authors
Issue Date2003
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jtoc/106570021
Citation
Liver Transplantation, 2003, v. 9 n. 12, p. 1265-1272 How to Cite?
AbstractInclusion of the middle hepatic vein (MHV) in a right lobe graft is essential to guarantee uniform venous drainage and optimum function of the graft, but end-to-end recipient-to-donor MHV anastomosis may result in outflow obstruction. To avoid outflow obstruction, we designed the venoplasty technique. From September 2000 to November 2002, 65 adult patients received right lobe live donor liver transplantation (LDLT) with grafts containing the right hepatic vein (RHV) and MHV. In the first 34 recipients, the graft RHV and MHV were anastomosed to the recipients' RHV and MHV/left hepatic vein, respectively. For the subsequent 31 recipients, the MHV was joined to the RHV at the back table to form a triangular common orifice. The septum in between the two hepatic veins was divided at the middle and sutured transversely to remove the ridge in between and to create a large opening. The common orifice was anastomosed to a matched-size triangular opening in the recipient's inferior vena cava. After reperfusion, the presence of triphasic pulsatility on spectral Doppler tracing was regarded as a sign of perfect reconstruction. In the first group, Doppler study showed little flow in the MHV in 3 patients, absent pulsatility in the MHV after portal vein reperfusion in 4 patients, and absent pulsatility in the MHV after hepatic artery reperfusion in 5 patients. In the second group, excellent triphasic pulsatility was seen in all except 1 patient (12 of 34 versus 1 of 31, P = .001). A significant increase in the peak flow velocity was seen in the MHV in the second group (median, 19.45 cm/sec versus 31.4 cm/sec, P<.001). Less time was required to complete the hepatic vein anastomoses in the second group (40 minutes versus 27 minutes, P<.001. In conclusion, hepatic venoplasty technique facilitates the implantation of the right lobe graft and guarantees outflow in the MHV.
Persistent Identifierhttp://hdl.handle.net/10722/84439
ISSN
2015 Impact Factor: 3.951
2015 SCImago Journal Rankings: 1.763
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLiu, CLen_HK
dc.contributor.authorZhao, Yen_HK
dc.contributor.authorLo, CMen_HK
dc.contributor.authorFan, STen_HK
dc.date.accessioned2010-09-06T08:52:58Z-
dc.date.available2010-09-06T08:52:58Z-
dc.date.issued2003en_HK
dc.identifier.citationLiver Transplantation, 2003, v. 9 n. 12, p. 1265-1272en_HK
dc.identifier.issn1527-6465en_HK
dc.identifier.urihttp://hdl.handle.net/10722/84439-
dc.description.abstractInclusion of the middle hepatic vein (MHV) in a right lobe graft is essential to guarantee uniform venous drainage and optimum function of the graft, but end-to-end recipient-to-donor MHV anastomosis may result in outflow obstruction. To avoid outflow obstruction, we designed the venoplasty technique. From September 2000 to November 2002, 65 adult patients received right lobe live donor liver transplantation (LDLT) with grafts containing the right hepatic vein (RHV) and MHV. In the first 34 recipients, the graft RHV and MHV were anastomosed to the recipients' RHV and MHV/left hepatic vein, respectively. For the subsequent 31 recipients, the MHV was joined to the RHV at the back table to form a triangular common orifice. The septum in between the two hepatic veins was divided at the middle and sutured transversely to remove the ridge in between and to create a large opening. The common orifice was anastomosed to a matched-size triangular opening in the recipient's inferior vena cava. After reperfusion, the presence of triphasic pulsatility on spectral Doppler tracing was regarded as a sign of perfect reconstruction. In the first group, Doppler study showed little flow in the MHV in 3 patients, absent pulsatility in the MHV after portal vein reperfusion in 4 patients, and absent pulsatility in the MHV after hepatic artery reperfusion in 5 patients. In the second group, excellent triphasic pulsatility was seen in all except 1 patient (12 of 34 versus 1 of 31, P = .001). A significant increase in the peak flow velocity was seen in the MHV in the second group (median, 19.45 cm/sec versus 31.4 cm/sec, P<.001). Less time was required to complete the hepatic vein anastomoses in the second group (40 minutes versus 27 minutes, P<.001. In conclusion, hepatic venoplasty technique facilitates the implantation of the right lobe graft and guarantees outflow in the MHV.en_HK
dc.languageengen_HK
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jtoc/106570021en_HK
dc.relation.ispartofLiver Transplantationen_HK
dc.rightsLiver Transplantation. Copyright © John Wiley & Sons, Inc.en_HK
dc.titleHepatic venoplasty in right lobe live donor liver transplantationen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1527-6465&volume=9&issue=12&spage=1265&epage=1272&date=2003&atitle=Hepatic+venoplasty+in+right+lobe+live+donor+liver+transplantationen_HK
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hken_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.authorityLo, CM=rp00412en_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.lts.2003.09.014en_HK
dc.identifier.pmid14625826-
dc.identifier.scopuseid_2-s2.0-0346777297en_HK
dc.identifier.hkuros90468en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0346777297&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume9en_HK
dc.identifier.issue12en_HK
dc.identifier.spage1265en_HK
dc.identifier.epage1272en_HK
dc.identifier.isiWOS:000186910900005-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLiu, CL=7409789712en_HK
dc.identifier.scopusauthoridZhao, Y=7407402718en_HK
dc.identifier.scopusauthoridLo, CM=7401771672en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK

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