Florence Nightingale Hospital, Center for Organ Transplantation, Abide-i Hurriyet Caddesi No: 290 Sisli, Istanbul, Turkey.
Transpl Int. 2010 Mar 1;23(3):285-91. doi: 10.1111/j.1432-2277.2009.00978.x. Epub 2009 Oct 12.
The harvesting of the middle hepatic vein (MHV) with the right lobe graft for living-donor liver transplantation allows an optimal venous drainage for the recipient; however, it is an extensive operation for the donor. This is a prospective, nonrandomized study evaluating liver functions and early clinical outcome in donors undergoing right hepatectomy with or without MHV harvesting. From August 2005 to July 2007, a total of 100 donor right hepatectomies were performed with (n = 49) or without (n = 51) the inclusion of the MHV. The decision to take MHV was based on an algorithm that considers various donor and recipient factors. There was no donor mortality in donors in either group. Overall complication rate was higher in MHV (+) donor group, however when remnant liver volume was kept above 30%, complication rates were similar between the groups. The results of this study show that right hepatectomy including the MHV neither affects morbidity nor impairs early liver function in donors when remnant volume is kept above 30%. The decision, therefore, of the extent of right lobe donor hepatectomy should be tailored to the particular conditions considering the graft quality and metabolic demand of the recipient.
肝中静脉（MHV）的采集和右叶供肝用于活体肝移植可使受者获得最佳的静脉引流；然而，对供者来说，这是一项广泛的手术。这是一项前瞻性、非随机研究，评估了在不包括或包括 MHV 采集的情况下行右半肝切除术的供者的肝功能和早期临床结果。2005 年 8 月至 2007 年 7 月，共进行了 100 例供者右半肝切除术，其中包括 MHV（n = 49）或不包括 MHV（n = 51）。是否采集 MHV 的决定是基于一个考虑各种供者和受者因素的算法。两组供者均无死亡。尽管 MHV（+）供者组的总体并发症发生率较高，但当剩余肝体积保持在 30%以上时，两组的并发症发生率相似。这项研究的结果表明，当剩余肝体积保持在 30%以上时，包括 MHV 的右半肝切除术既不会影响供者的发病率，也不会损害其早期肝功能。因此，右半肝供者肝切除术的范围应根据供肝质量和受者代谢需求等特定情况进行调整。
