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academies
Journal of Gastroenterology and Digestive Diseases | Volume 3
May 25-26, 2018 | New York, USA
World Liver Conference 2018
Introduction:
Right lobe graft providing adequate functional
liver mass to recipient without compromising donor safety,
is well-established surgical treatment for end stage liver
disease in adult.
Material and Methods:
We adopted tailored approach for
MHV retrieval in 665 RL-LDLTs (Jan2013-Aug2015) based
primarily on three factors volumes, anatomy and metabolic
demand. Donor paramaters included were remanant
volume, age, sex, BMI, segment IV venous drainage,MHV
anatomy, Middle vein dominance, size of segment V and
VIII veins. Recipient factors were GRWR,MELD score(disease
MELD) and severity of portal hypertension
Results:
347 patients received graft with MHV, 318 without
MHV. Outcomes in donors and recipients were comparable.
RLG without MHV was retrieved in 15 out of 18 donors with
steatosis more than 10%. GRWR, cold ischemia time(CIT)
was significantly more and remnant volume less in non
MHV group. 29.3%of donors had complication (26%Clavien-
Dindo grade I, II) with no statistically significant difference
among groups. MELD score was higher in MERLG group. One
and three year patient survival was similar among different
GRWR and type of RLG groups.
Conclusion:
Selective and tailored approach for right lobe
donor hepatectomy based on optimal functional volume and
metabolic demands of both recipient and donor addresses
both key issues in LDLT, optimal recipient outcomes and
donor safety.
Right lobe live liver donation-safe approach
Sanjay Goja
Institute of Liver Transplantation and Regenerative Medicine, India