Selection of the right lobe liver graft from living family donor

O.H. Kotenko, A.A. Minich, O.V. Hrynenko, O.O. Popov, A.V. Husiev, M.S. Hryhorian, D.O. Fedorov, V.I. Yednak


Background. Objective: to determine the key criteria for selecting the right lobe liver graft of an adequate functional mass. Materials and methods. Based on the algorithm developed by us, which included the analysis of the variation anatomy of the donor liver veins with determination of the dominant vein type, transplants were selected for 75 recipients: 37 patients (group 1) received the right liver lobe with median vein, and 38 persons (group 2) — the right lobe without median vein. For comparative analysis, data of biochemical blood parameters from both groups were used during the first week and on 10, 14, 21, 30 days after transplantation. Results. Using the described algorithm for graft selection, we obtained the following results: peak values of alanine aminotransferase, aspartate aminotransferase and total bilirubin levels were slightly higher in group 2 (384.43; 399.77 and 206.70, respectively), compared with group 1 (212.64; 285.57; 203.18, respectively). There was no significant difference between the level of gamma-glutamyltransferase, alkaline phosphatase, prothrombin time and international normalized ratio. Conclusions. With the dominant type of the median hepatic vein in the right lobe grafts, it is necessary to take the right hepatic lobe with median vein. In case when the right vein is the dominant one — of the right hepatic lobe without median vein. An adequate venous outflow, with sufficient volume of the right hepatic graft, determines the functional mass of the graft.


liver; graft; venous outflow; functional mass


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