A new technique to acquire additional liver volume for left lobe graft in living donor liver transplantation

Satoru Imura, Mitsuo Shimada, Kotaro Miyake, Tetsuya Ikemoto, Yuji Marine, Tomoharu Yoshizumi

研究成果: ジャーナルへの寄稿記事

8 引用 (Scopus)

抄録

Background/Aims: Left lobe graft is an ideal option to minimize potential risk for the donor in adult living-donor liver transplantation (LDLT). However, its use is restricted due to size limitations. The purpose of this study was to determine the impact of a new technique for the acquisition of additional liver volume for left lobe graft. Methodology: Three donors underwent left hepatic lobectomy by exploiting a new technique as follows: a demarcation line was marked by clamping the right first Glisson's pedicle. A parenchymal transection plane was located 1cm right side from the demarcation line and just on the left side of the right anterior Glisson's pedicle. A part of the anterior segment added to the left lobe graft by this procedure belonged to right anterior segment by preoperative CT. The preoperative volumetry of the liver was performed using the 3D-CT software, which was able to calculate total liver volume and the volume of each vessel's territories. Additional liver volume was calculated by preoperative CT scan and defined as part of the perfusion area by the right anterior portal branch. Blood perfusion of the additional liver area was postoperatively assessed by dynamic CT, and graft outcome was also evaluated. Results: An additional gain ranged from 40mL to 51mL (mean 41.8mL). GV/SLV was 35.7, 60.0, and 41.0%. The rate of additional volume in GV/SLV ranged from 7.2-8.4% (mean 7.6%). All grafts functioned well. The CT scan performed on early postoperative period confirmed excellent blood perfusion the additional segment. No complication attributable to small-for-size graft was noted. Conclusions: This new technique for left lobe graft harvesting proved a promising approach to gain additional volume, thereby avoiding small-for-size graft in adult LDLT.

元の言語英語
ページ(範囲)1206-1210
ページ数5
ジャーナルHepato-Gastroenterology
55
発行部数85
出版物ステータス出版済み - 7 2008
外部発表Yes

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Living Donors
Liver Transplantation
Transplants
Liver
Perfusion
Tissue Donors
Postoperative Period
Constriction
Software

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

これを引用

A new technique to acquire additional liver volume for left lobe graft in living donor liver transplantation. / Imura, Satoru; Shimada, Mitsuo; Miyake, Kotaro; Ikemoto, Tetsuya; Marine, Yuji; Yoshizumi, Tomoharu.

:: Hepato-Gastroenterology, 巻 55, 番号 85, 07.2008, p. 1206-1210.

研究成果: ジャーナルへの寄稿記事

Imura, S, Shimada, M, Miyake, K, Ikemoto, T, Marine, Y & Yoshizumi, T 2008, 'A new technique to acquire additional liver volume for left lobe graft in living donor liver transplantation', Hepato-Gastroenterology, 巻. 55, 番号 85, pp. 1206-1210.
Imura, Satoru ; Shimada, Mitsuo ; Miyake, Kotaro ; Ikemoto, Tetsuya ; Marine, Yuji ; Yoshizumi, Tomoharu. / A new technique to acquire additional liver volume for left lobe graft in living donor liver transplantation. :: Hepato-Gastroenterology. 2008 ; 巻 55, 番号 85. pp. 1206-1210.
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abstract = "Background/Aims: Left lobe graft is an ideal option to minimize potential risk for the donor in adult living-donor liver transplantation (LDLT). However, its use is restricted due to size limitations. The purpose of this study was to determine the impact of a new technique for the acquisition of additional liver volume for left lobe graft. Methodology: Three donors underwent left hepatic lobectomy by exploiting a new technique as follows: a demarcation line was marked by clamping the right first Glisson's pedicle. A parenchymal transection plane was located 1cm right side from the demarcation line and just on the left side of the right anterior Glisson's pedicle. A part of the anterior segment added to the left lobe graft by this procedure belonged to right anterior segment by preoperative CT. The preoperative volumetry of the liver was performed using the 3D-CT software, which was able to calculate total liver volume and the volume of each vessel's territories. Additional liver volume was calculated by preoperative CT scan and defined as part of the perfusion area by the right anterior portal branch. Blood perfusion of the additional liver area was postoperatively assessed by dynamic CT, and graft outcome was also evaluated. Results: An additional gain ranged from 40mL to 51mL (mean 41.8mL). GV/SLV was 35.7, 60.0, and 41.0{\%}. The rate of additional volume in GV/SLV ranged from 7.2-8.4{\%} (mean 7.6{\%}). All grafts functioned well. The CT scan performed on early postoperative period confirmed excellent blood perfusion the additional segment. No complication attributable to small-for-size graft was noted. Conclusions: This new technique for left lobe graft harvesting proved a promising approach to gain additional volume, thereby avoiding small-for-size graft in adult LDLT.",
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T1 - A new technique to acquire additional liver volume for left lobe graft in living donor liver transplantation

AU - Imura, Satoru

AU - Shimada, Mitsuo

AU - Miyake, Kotaro

AU - Ikemoto, Tetsuya

AU - Marine, Yuji

AU - Yoshizumi, Tomoharu

PY - 2008/7

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N2 - Background/Aims: Left lobe graft is an ideal option to minimize potential risk for the donor in adult living-donor liver transplantation (LDLT). However, its use is restricted due to size limitations. The purpose of this study was to determine the impact of a new technique for the acquisition of additional liver volume for left lobe graft. Methodology: Three donors underwent left hepatic lobectomy by exploiting a new technique as follows: a demarcation line was marked by clamping the right first Glisson's pedicle. A parenchymal transection plane was located 1cm right side from the demarcation line and just on the left side of the right anterior Glisson's pedicle. A part of the anterior segment added to the left lobe graft by this procedure belonged to right anterior segment by preoperative CT. The preoperative volumetry of the liver was performed using the 3D-CT software, which was able to calculate total liver volume and the volume of each vessel's territories. Additional liver volume was calculated by preoperative CT scan and defined as part of the perfusion area by the right anterior portal branch. Blood perfusion of the additional liver area was postoperatively assessed by dynamic CT, and graft outcome was also evaluated. Results: An additional gain ranged from 40mL to 51mL (mean 41.8mL). GV/SLV was 35.7, 60.0, and 41.0%. The rate of additional volume in GV/SLV ranged from 7.2-8.4% (mean 7.6%). All grafts functioned well. The CT scan performed on early postoperative period confirmed excellent blood perfusion the additional segment. No complication attributable to small-for-size graft was noted. Conclusions: This new technique for left lobe graft harvesting proved a promising approach to gain additional volume, thereby avoiding small-for-size graft in adult LDLT.

AB - Background/Aims: Left lobe graft is an ideal option to minimize potential risk for the donor in adult living-donor liver transplantation (LDLT). However, its use is restricted due to size limitations. The purpose of this study was to determine the impact of a new technique for the acquisition of additional liver volume for left lobe graft. Methodology: Three donors underwent left hepatic lobectomy by exploiting a new technique as follows: a demarcation line was marked by clamping the right first Glisson's pedicle. A parenchymal transection plane was located 1cm right side from the demarcation line and just on the left side of the right anterior Glisson's pedicle. A part of the anterior segment added to the left lobe graft by this procedure belonged to right anterior segment by preoperative CT. The preoperative volumetry of the liver was performed using the 3D-CT software, which was able to calculate total liver volume and the volume of each vessel's territories. Additional liver volume was calculated by preoperative CT scan and defined as part of the perfusion area by the right anterior portal branch. Blood perfusion of the additional liver area was postoperatively assessed by dynamic CT, and graft outcome was also evaluated. Results: An additional gain ranged from 40mL to 51mL (mean 41.8mL). GV/SLV was 35.7, 60.0, and 41.0%. The rate of additional volume in GV/SLV ranged from 7.2-8.4% (mean 7.6%). All grafts functioned well. The CT scan performed on early postoperative period confirmed excellent blood perfusion the additional segment. No complication attributable to small-for-size graft was noted. Conclusions: This new technique for left lobe graft harvesting proved a promising approach to gain additional volume, thereby avoiding small-for-size graft in adult LDLT.

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