[Clinical living donor liver transplantation: a report of 4 cases]

To investigate principal surgical techniques of living donor liver transplantation (LDLT) .

A retrospective analysis was made in 4 cases undergoing living donor liver transplantation from Feb. 2003 to Nov. 2006.

All the living donors of 4 cases were adults, including the right lobe transplanted in 3 patients (not including the middle hepatic vein in 2, including the middle hepatic vein in one), the extended left lateral lobe (not including the middle hepatic vein) in one. The graft-to-recipient weight ratio (GRWR) was 0.85%-1.44%. The right hepatic vein reconstructions were performed in end to end anastomoses in 3 patients. The left and middle hepatic vein reconstruction was performed in end to end left hepatic vein of graft anastomosis in one. The arterial anastomoses were performed in end to end, including the right hepatic arteria of the graft to the hepatic proprial arteria in 2 patients, the branch of the right hepatic arteria of the graft through the radialis arteria to the hepatic proprial arteria in one, the left hepatic arteria of the graft to the hepatic proprial arteria in one. Biliary reconstructions were made by using duct to duct anastomoses, and placement of a T tube in 2 patients. All 4 donors were uneventfully discharged after operation. Four recipients were without vascular complication, and the stoma of bile duct was light stegnosis in a child recipient without "T" tube. They have been surviving 58 months, 32 months, 20 months and 14 months respectively.

The process of LDLT was complicated, and the surgical technique was difficult. Choosing suitable donors and flexible mastering of the principal surgical techniques can achieve favorable prognosis of LDLT.