Graft size assessment and analysis of donors for living donor liver transplantation using right lobe

Citation
S. Sakamoto et al., Graft size assessment and analysis of donors for living donor liver transplantation using right lobe, TRANSPLANT, 71(10), 2001, pp. 1407-1413
Citations number
21
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Medical Research Diagnosis & Treatment
Journal title
TRANSPLANTATION
ISSN journal
0041-1337 → ACNP
Volume
71
Issue
10
Year of publication
2001
Pages
1407 - 1413
Database
ISI
SICI code
0041-1337(20010527)71:10<1407:GSAAAO>2.0.ZU;2-S
Abstract
Background, Modality of living donor liver transplantation (LDLT) has been expanded to adult cases. However, the safety of right lobectomy from living donors has not yet been proven. Methods. A total of 62 cases of LDLT, using the right lobe, were reviewed. Study 1: Discrepancy between estimated graft volume and actual graft weight was evaluated. Study 2: Postoperative liver functions were analyzed in rel ation to residual liver volume (RLV) or age. Residual liver volume of donor s was defined using two indices, (RLV = estimated whole liver volume estima ted graft volume and %RLV = RLV/estimated whole liver volume x 100). Donors were divided into two groups on the basis of either %RLV (< 40%; 40%less t han or equal to) or age (< 50 years old; 50 years old less than or equal to ). Study 3: Right lobe donors were compared with left lobe donors (35 cases ) in terms of their postoperative liver functions. Results. Study 1: The relationship between estimated graft volume and actua l graft weight was linear (y= 159.136+ 0.735x, R-2=0.571, P <0.001). Study 2: %RLV ranged from 23.5% to 55.8% (mean +/- SD: 43.2 +/-6.0). Fifteen case s showed %RLV less than 40%, Postoperative bilirubin clearance was delayed in that group (%RLV < 40%). Serum total bilirubin values on postoperative d ay 7 in the older group (age greater than or equal to 50) were significantl y higher than those in the younger group (age < 50), Study 3: Postoperative liver functions of right lobe donors were significantly higher than those of left-lobe donors, Eleven donors (17.7%) had surgical complications, all of which were cured with proper treatment. Conclusions. Right lobectomy from living donors is a safe procedure with ac ceptable morbidity, but some care should be taken early after the operation for donors with small residual liver and aged donors.