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

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.

scholarly journals Anatomical and Surgical Basis for Adult Living Donor Liver Transplantation with the Right Liver Lobe

2014 ◽  
Vol 60 (3) ◽  
pp. 129-132
Author(s):  
C. Borz ◽  
D. Marian ◽  
T. Bara ◽  
O. Jimborean ◽  
T. Bara ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
Liver Graft ◽  
Main Concern ◽  
Donor Liver ◽  
Liver Lobe ◽  
Donor Liver Transplantation ◽  
Split Liver ◽  
The Right

Abstract Liver transplantation is now a standard procedure for the treatment of end stage liver diseases. Since 1968 until 2012, a number of 113,627 liver transplantations were performed in Europe, in 28 countries and 153 institutions. Despite these impressive figures the waiting list is growing every year. Transplant surgeons were preoccupied to find new ways to increase the donor pool. Among them: reduced size liver transplantation, split liver technique and more recently living donor liver transplantation. At first in the early `90, living donor liver transplantation was used for pediatric patients because the left lateral hepatic segments were harvested. This graft is too small for the metabolic demands of an adult patient. So the next step was the harvesting of the right liver lobe from the donor and transplantation to adult patients. Living donor liver transplantation has gained fast a wide acceptance but there are a few issues to discuss. The main concern is about the donor safety which is a healthy person undergoing major surgery with potential risks. Also the surgical technique evolved due to a better understanding of the anatomy and physiology of the liver and the right liver graft. We discuss here the anatomical and surgical basis for living donor liver transplantation with the right liver lobe.

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

2012 ◽  
Vol 12 (6) ◽  
pp. 1511-1518 ◽  
Author(s):  
K.-M. Chan ◽  
F. Z. Eldeen ◽  
C.-F. Lee ◽  
T.-J. Wu ◽  
H.-S. Chou ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Graft ◽  
Adult Liver ◽  
Left Liver

Biliary complications following adult right lobe ex vivo split liver transplantation

2006 ◽  
Vol 12 (5) ◽  
pp. 839-844 ◽  
Author(s):  
Maciej Wojcicki ◽  
Michael A. Silva ◽  
Paras Jethwa ◽  
Bridget Gunson ◽  
Simon R. Bramhall ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Ex Vivo ◽  
Biliary Complications ◽  
Split Liver Transplantation ◽  
Split Liver ◽  
Right Lobe

scholarly journals Ex vivo split-liver transplantation: the true right/left split

HPB ◽  
2014 ◽  
Vol 16 (3) ◽  
pp. 267-274 ◽  
Author(s):  
Parsia A. Vagefi ◽  
Justin Parekh ◽  
Nancy L. Ascher ◽  
John P. Roberts ◽  
Chris E. Freise
Keyword(s):  
Liver Transplantation ◽  
Ex Vivo ◽  
Split Liver Transplantation ◽  
Split Liver

scholarly journals Ex-vivo Liver Splitting during Hypothermic Oxygenated Perfusion: A Novel Procedure to Optimize Graft Preservation in Split Liver Transplantation

HPB ◽  
2021 ◽  
Vol 23 ◽  
pp. S690-S691
Author(s):  
G. Rossignol ◽  
X. Muller ◽  
M. Lesurtel ◽  
R. Dubois ◽  
K. Mohkam ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Ex Vivo ◽  
Split Liver Transplantation ◽  
Graft Preservation ◽  
Split Liver

Elevated Risk of Split‐Liver grafts in adult liver Transplantation: Statistical Artifact or Nature of the Beast?

2019 ◽  
Vol 25 (5) ◽  
pp. 741-751 ◽  
Author(s):  
Kazunari Sasaki ◽  
Daniel J. Firl ◽  
John C. McVey ◽  
Jesse D. Schold ◽  
Giuseppe Iuppa ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Elevated Risk ◽  
Adult Liver ◽  
Split Liver ◽  
Statistical Artifact

scholarly journals Salvage with a Secondary Infrahepatic Cavocavostomy of the Occluded Modified Piggyback Anastomosis during Split Liver Transplantation: A Case Report

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Erdem Kinaci ◽  
Cuneyt Kayaalp ◽  
Sezai Yilmaz ◽  
Emrah Otan
Keyword(s):  
Liver Transplantation ◽  
Vena Cava ◽  
Liver Graft ◽  
Outflow Obstruction ◽  
Venous Outflow ◽  
Hepatic Venous Outflow Obstruction ◽  
Split Liver ◽  
Hepatic Venous Outflow ◽  
Venous Outflow Obstruction ◽  
Right Lobe

Hepatic venous outflow obstruction following liver transplantation is rare but disastrous. Here we described a 14-year-old boy who underwent a split right lobe liver transplantation with modified (side-to-side) piggyback technique which resulted in hepatic venous outflow obstruction. When the liver graft was lifted up, the outflow drainage returned to normal but when it was placed back into the abdomen, the outflow obstruction recurred. Because reanastomosis would have resulted in hepatic reischemia, alternatively, a second infrahepatic cavocavostomy was planned without requiring hepatic reischemia. During this procedure, the first assistant hung the liver up to provide sufficient outflow and the portal inflow of the graft continued as well. We only clamped the recipient’s infrahepatic vena cava and the caudal cuff of the graft cava. After the second end-to-side cavocaval anastomosis, the graft was placed in its orthotopic position and there was no outflow problem anymore. The patient tolerated the procedure well and there were no problems after three months of follow-up. A second cavocavostomy can provide an extra bypass for some hepatic venous outflow problems after piggyback anastomosis by avoiding hepatic reischemia.

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