Background. Caudate lobe transplantation with an extended left lobe graft is an innovative and promising method for increasing the graft volume in living donor liver transplantation. However, little is known about the fate of the caudate lobe after transplantation. Methods. Eight extended left lobe grafts with the caudate lobe were included in this study. No attempt was made to reconstruct the short hepatic veins. On the basis of the computed tomography scans that were obtained before the operation and 1 month after the transplantation, the increase in the graft volume by the addition of the caudate lobe and the changes in the transplanted caudate lobe were evaluated. Results. The addition of the caudate lobe increased the graft volume by 25 ± 2 g, corresponding to a 2% increase in graft volume/standard liver volume ratio. One month after the transplantation, the caudate lobe volume increased in all patients but 1. The regeneration rate of the caudate lobe and other segments (segments II-IV) 1 month after transplantation was 62% ± 24% (24 ± 4 mL-37 ± 4 mL) and 152% ± 35% (374 ± 45 mL-930 ± 65 mL), respectively (P < .01). Conclusions. This technique affords a modest increase in liver volume with living donor left liver procurement.
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