Donor right hepatectomy in living donor liver transplantation: report of 143 cases.

摘要

BACKGROUND/AIMS: To summarize the surgical techniques of liver resection for right hepatic lobe graft in living donor liver transplantation (LDLT). METHODOLOGY: Data of 143 living donors of right hepatic lobe graft from January 2002 to February 2009 were retrospectively studied. The right lobe grafts were obtained by transecting the liver on the right side of the middle hepatic vein. Liver transection was done by using an ultrasonic dissector without inflow vascular occlusion. The standard liver volume (SLV) and the ratio of right lobe volume to SLV were calculated. RESULTS: The weight of right hepatic lobe graft ranged from 310 g to 870 g, accounting for 39.7-69.5% of SLV with the ratio of residual left liver from 30.5% to 60.3%, corresponding to 31.7%-71.6% of the recipient SLV. The mean operative loss of blood was 428 ml. Complications included 2 cases of intraabdominal bleeding, 1 thrombosis of the portal vein, 1 liver function insufficiency, 3 bile leakages, 1 chyle leakage, 2 pleural effusions and 5 wound steatoses. At last, all donors restored to health. CONCLUSIONS: Estimation of the liver volume by CT or formulae and accurate donor hepatectomy is of clinical importance in planning and performing successful living donor liver transplantation.