ISSN: 1859 - 2872
Comparison of outcomes of living donor liver transplantation using a right liver graft with or without the middle hepatic vein
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Abstract
Objective: To compare the outcomes of living donor liver transplantation using right liver grafts with and without the middle hepatic vein (MHV). Subject and method: A retrospective study was conducted on 149 liver donation cases in which a right liver graft was harvested with or without the inclusion of the MHV, from October 2017 to December 2022 at 108 Military Central Hospital. Result: The number of male donors in the group with the right liver graft including the MHV (68 donors) was significantly higher than in the group without the MHV (48 donors), with p=0.02. The percentage of residual left liver volume after surgery did not differ significantly between the two groups (36.11 ± 3.38% vs. 39.45 ± 4.38%, p=0.29). The parenchymal transection time in the MHV group was significantly longer compared to the group without the MHV (64.56 ± 17.81 minutes vs. 59.03 ± 23.41 minutes, p=0.05). There were no significant differences between the two groups in terms of total operative time, blood loss, or the proportion of patients requiring blood transfusions. The complication rates were similar between the groups (7.25% vs. 8.25%). The left liver volume measured on postoperative day 7 in the group with the right liver graft including the MHV was significantly higher than that in the group without the MHV (852.08 ± 122.28mL vs. 794.15 ± 136.89mL, p=0.01). The total bilirubin level on postoperative day 1 was higher in the MHV group than in the non-MHV group (40.54 ± 21.84μmol/L vs. 34.25 ± 15.29μmol/L, p=0.02), and the prothrombine ratio on postoperative day 3 differed significantly between the two groups (p=0.01). Conclusion: Right liver graft harvesting surgery, whether including or excluding the middle hepatic vein, in living donors for liver transplantation yields good outcomes with no difference in complication rates between the two groups. The decision to use a right liver graft with the middle hepatic vein is made on a case-by-case basis.
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References
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