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Correlation between drainage area volume of middle hepatic vein and liver function
Junichi Kaneko1, Yasuhiko Sugawara, Yuuichi Matsui
1Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine University of Tokyo, Japan.
Insights
Predicting middle hepatic vein (MHV) drainage area volume in living liver donors is crucial. This study found that calculated MHV drainage volume correlates with early liver function after left liver graft harvesting.
Area of Science:
- Hepatobiliary surgery
- Transplant surgery
- Liver regeneration
Background:
- Maintaining complete outflow is challenging in hemi-liver graft harvesting due to unilateral preservation of the middle hepatic vein (MHV).
- Disruption of outflow veins leads to congestion and inadequate regeneration in the affected liver area.
Purpose of the Study:
- To develop a method for predicting the middle hepatic vein (MHV) drainage area volume in living liver donors.
- To assess the correlation between MHV drainage area volume and early liver function post-donation.
Main Methods:
- Studied 55 living donors undergoing left liver graft donation including the caudate lobe and MHV.
- Utilized computed tomography (CT) to determine the midpoint between MHV and right hepatic vein tributaries preoperatively.
- Calculated MHV drainage area volume based on CT measurements and liver borderlines.
Main Results:
- Total bilirubin, prothrombin time (PT) international normalized ratio (INR), and alanine aminotransferase (ALT) were monitored postoperatively.
- MHV drainage area volume correlated with total bilirubin on postoperative days 5 and 7.
- Correlation was also observed with PT INR on day 3 and ALT on day 7.
Conclusions:
- The developed method for calculating MHV drainage area volume is a reliable predictor.
- Calculated MHV drainage area volume correlates with early liver function indicators following left liver donation with MHV preservation.
Background/Aims:
Complete outflow is impossible to maintain on both sides in donors undergoing hemi-liver graft harvesting, because the middle hepatic vein (MHV) can be preserved on only one side. The area in which outflow veins are disrupted becomes congested, and does not sufficiently regenerate.
Methodology:
The subjects of the study were 55 living donors who provided the left liver with caudate lobe, including the MHV. The midpoint between the tributaries of the MHV and the right hepatic vein was determined preoperatively with computed tomography. The midpoint between the tributaries of the MHV and right hepatic vein and the borderline between the right and left liver were used to predict the MHV drainage area volume. Total bilirubin levels, the prothrombin time international normalization ratio, and alanine aminotransferase were measured in donors on postoperative days 1, 3, 5 and 7.
Results:
The parameters that correlated with the MHV drainage area volume included total bilirubin on days 5 and 7, prothrombin time international normalization ratio on day 3, and alanine aminotransferase on day 7.
Conclusions:
Middle hepatic vein drainage area volume, calculated using the present method, correlated with early liver function after left liver harvesting with the MHV.
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