論文

査読有り 国際誌
2020年6月30日

Living-donor liver transplantation: right versus left.

International journal of surgery (London, England)
  • Shintaro Yagi
  • ,
  • Ashish Singhal
  • ,
  • Dong-Hwan Jung
  • ,
  • Koji Hashimoto

記述言語
英語
掲載種別
DOI
10.1016/j.ijsu.2020.06.022

A dilemma of graft selection between right or left livers occurs during the planning of living-donor liver transplantation (LDLT) as well as splitting a whole liver graft into full right/full left grafts in deceased-donor liver transplantation. The right liver's relation to the whole liver could be considered as the trunk of a tree; it has a larger volume, the main axis of bile ducts, and the inferior vena cava mainly belongs to the right liver. Therefore, it was considered as the standard graft in LDLTs. Whether to procure the middle hepatic vein (MHV) with a right liver graft or to leave it attached to the left-liver remnant largely depends on the transplant institute. Recently, most transplant institutes tend to leave the MHV with the left liver for the sake of donor safety. Unlike hepatectomy for liver tumors, it is vital to preserve inflow and outflow for both the resected as well as the remaining livers. While procuring any graft type, the most important is to procure a liver graft with reconstructable portal veins, hepatic arteries, hepatic veins, and bile ducts, which should be well preoperatively planned using 3D-computed tomography with considerations given to graft volume and potential congestion areas.

リンク情報
DOI
https://doi.org/10.1016/j.ijsu.2020.06.022
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/32619620
ID情報
  • DOI : 10.1016/j.ijsu.2020.06.022
  • PubMed ID : 32619620

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