“Left at Right” Adult Liver Transplantation: The Feasibility of Heterotopic Implantation of Left Liver Graft

Abstract Plasma levels of coagulation factors differ profoundly between adults and children, but are remarkably stable throughout adulthood. It is unknown which factors determine plasma levels of coagulation factors in a given individual. We hypothesized that the liver, which synthesizes coagulation factors, also controls plasma levels. We measured a panel of coagulation factors in samples taken from either adults or young children who underwent a liver transplantation with adult donor livers. Samples were taken 1-3 months after transplantation, when the patients were clinically stable with adequate graft function. After liver transplantation, the hemostatic profile of the pediatric group was remarkably different from that of the adult group, and resembled the hemostatic profile of normal children. Thus, children transplanted with an adult liver graft maintain a pediatric hemostatic profile after transplantation despite receiving an adult liver graft. These findings suggest that plasma levels of hemostatic proteins are not controlled by the liver.

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Impact of Short Hepatic Vein Reconstruction in Living Donor Adult Liver Transplantation Using a Left Liver Plus Caudate Lobe Graft

Asian Journal of Surgery ◽

10.1016/s1015-9584(10)60002-4 ◽

2010 ◽

Vol 33 (1) ◽

pp. 8-13 ◽

Cited By ~ 2

Author(s):

Koji Mikami ◽

Nobuhide Matsuoka ◽

Takafumi Maekawa ◽

Yasushi Yamauchi ◽

Tomoaki Noritomi ◽

...

Keyword(s):

Liver Transplantation ◽

Hepatic Vein ◽

Living Donor ◽

Caudate Lobe ◽

Adult Liver ◽

Left Liver ◽

Hepatic Vein Reconstruction

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Living Donor Liver Transplantation with Left Liver Graft

American Journal of Transplantation ◽

10.1111/j.1600-6143.2004.00548.x ◽

2004 ◽

Vol 4 (10) ◽

pp. 1713-1716 ◽

Cited By ~ 45

Author(s):

Michele Masetti ◽

Antonio Siniscalchi ◽

Lesley De Pietri ◽

Vanessa Braglia ◽

Fabrizio Di Benedetto ◽

...

Keyword(s):

Liver Transplantation ◽

Living Donor ◽

Living Donor Liver Transplantation ◽

Liver Graft ◽

Donor Liver ◽

Donor Liver Transplantation ◽

Left Liver

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A Novel Strategy for Preventing Posttransplant Large-For-Size Syndrome in Adult Liver Transplant Recipients: A Pilot Study

Transplant International ◽

10.3389/ti.2021.10177 ◽

2022 ◽

Vol 35 ◽

Author(s):

Xingyu Pu ◽

Diao He ◽

Anque Liao ◽

Jian Yang ◽

Tao Lv ◽

...

Keyword(s):

Liver Transplantation ◽

Ex Vivo ◽

Liver Graft ◽

Fascial Closure ◽

Adult Liver ◽

Split Liver ◽

Liver Transplantations ◽

Novel Strategy ◽

The Right ◽

Right Posterior Sectionectomy

There are two causes of graft compression in the large-for-size syndrome (LFSS). One is a shortage of intra-abdominal space for the liver graft, and the other is the size discrepancy between the anteroposterior dimensions of the liver graft and the lower right hemithorax of the recipient. The former could be treated using delayed fascial closure or mesh closure, but the latter may only be treated by reduction of the right liver graft to increase space. Given that split liver transplantation has strict requirements regarding donor and recipient selections, reduced-size liver transplantation, in most cases, may be the only solution. However, surgical strategies for the reduction of the right liver graft for adult liver transplantations are relatively unfamiliar. Herein, we introduce a novel strategy of HuaXi-ex vivo right posterior sectionectomy while preserving the right hepatic vein in the graft to prevent LFSS and propose its initial indications.

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