Intraoperative assessment of hepatic venous congestion with direct clamping of the hepatic vein trunk for living donor liver transplantation

Transplantation Proceedings
Shin HwangK B Oh

Abstract

We devised a hepatic vein clamping method to assess the amount of hepatic venous congestion (HVC) before liver transection. From February 2003 to May 2003, this method was applied to 5 of 58 living donor livers especially to assess donor safety. The left portal vein and proper hepatic artery as well as the middle hepatic vein (MHV)-left hepatic vein (LHV) trunk were clamped simultaneously to assess the HVC in the remnant right lobe before performing extended left lobectomy. As three donors demonstrated the extent of the HVC equivalent to about 40% of the right lobe volume (RLV), their operations proceeded according to the preoperative plan. The territory of HVC after liver transection was the same as that observed with direct clamping of the hepatic vein. However, one donor showed massive HVC more than 50% of RLV and the operative plan was adjusted to harvest only the left lobe without the MHV trunk for donor safety. To assess the HVC in the remnant left lobe, the isolated LHV trunk was occluded after clamping the donor's proper hepatic artery. The whole left lobe except for a small area at the anterior portion of the medial segment became discolored on LHV clamping: the opposite demarcation appeared on MHV clamping. The amount...Continue Reading

Citations

Oct 1, 2013·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·S M P BalzanM L Dotto
Dec 29, 2004·Transplantation Proceedings·S HwangT Y Ha
Sep 3, 2013·Orvosi hetilap·Attila SzijártóUemoto Shinji
Jun 19, 2013·Transplantation Proceedings·D B MoonC S Park
Jun 19, 2013·Transplantation Proceedings·D-B MoonC-S Park
May 25, 2006·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Shin HwangGi-Won Song
Mar 19, 2005·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Shin HwangYeon-Dae Kim
May 26, 2005·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Shin HwangTae-Yong Ha
Jan 1, 2008·BioFactors·Hea Jin ParkClifton A Baile
Feb 18, 2021·Current Opinion in Organ Transplantation·Hillary J Braun, John P Roberts

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