Background. A continuing shortage of cadaveric liver even for adult patient
s has motivated not a few centers to proceed to living-donor liver transpla
ntation using right lobe grafts. One of controversies is potential congesti
on in the graft anterior segment by the deprivation of the middle hepatic v
Methods. Hepatic tissue oxygenation and hemoglobin concentration were inves
tigated with a near-infrared spectroscopy in the course of harvesting and i
mplantation in living-donor liver transplantation. Twenty adult recipients
of right lobe graft were involved in the study. The aim of the analysis was
to detect tissue congestion or ischemia.
Results. No significant change in mean hepatic tissue oxygenation and hemog
lobin was noted in the right lobe during donor operation even after hepatic
parenchymal transection, although some trend for relative congestion, i.e.
, increased tissue hemoglobin, compared with the left lobe was observed. Af
ter graft reperfusion in the recipient, both mean hepatic tissue oxygen sat
uration and hemoglobin decreased significantly in the anterior segment, whi
ch was accompanied by increased heterogeneity of tissue hemoglobin and oxyg
enation. Increased heterogeneity of oxygenation and decreased tissue hemogl
obin were observed also in the posterior segment.
Conclusions. The anterior segment in right lobe living-donor liver transpla
ntation is sensitive to ischemia, rather than congestion, at least in the i
mmediate phase after graft reperfusion. The anterior segment seems to be al
so more prone to circulatory disturbance than the other part of the graft.