Tsang L L-C, Tung Y-C, Hsu H-W, Ou H-Y, Yu C-Y, Huang T-L, Chen C-L, Cheng Y-F
Departments of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Departments of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Transplant Proc. 2016 May;48(4):1015-7. doi: 10.1016/j.transproceed.2015.12.123.
Liver regeneration and donor safety in right-lobe (RL) and left-lobe (LL) grafts are essential for donors in living donor liver transplantation (LDLT). Our aim was to compare the liver regeneration rate and postoperative outcome between different donor graft types in LDLT.
A total of 95 donors were divided into 2 groups: RL (n = 42) and LL (n = 53). The remnant liver of LL donors were subdivided into 3 subgroups according to the different hepatic venous drainage pattern that dominates from right hepatic vein (dominant RHV; n = 34), middle hepatic vein (dominant MHV; n = 10), and include MHV for left lateral segment (LLS) graft (n = 9). The demographic data, postoperative laboratory data, complications, remnant liver volume (RLV), and remnant liver regeneration rate (RLRR) 6 months after surgery were compared.
The postoperative total bilirubin (TB), prothrombin time (PT), and intensive care unit (ICU) stays of the LL group were lower than the RL group (P < .05). The LL group has no significant better regeneration rate 6 months after surgery than the RL group. However, dominant RHV and LLS groups have significantly better RLRR than the RL group (89.2% vs 86% and 95.1% vs 86%, respectively, P < .05), but no significance in the dominant MHV group.
In conclusion, different hepatic venous drainage patterns of remnant liver grafts may affect the regeneration rate in LL LDLT, especially with dominant RHV donors, may have more comparable outcomes with that of RL, and should be a favorable option during donor selection.
在活体肝移植（LDLT）中，右叶（RL）和左叶（LL）移植物的肝再生及供体安全性对供体至关重要。我们的目的是比较LDLT中不同供体移植物类型之间的肝再生率及术后结局。
总共95例供体被分为2组：RL组（n = 42）和LL组（n = 53）。LL供体的残余肝根据不同的肝静脉引流模式被细分为3个亚组，即主要由右肝静脉引流（主要RHV；n = 34）、主要由中肝静脉引流（主要MHV；n = 10）以及左外叶（LLS）移植物包括中肝静脉引流（n = 9）。比较了人口统计学数据、术后实验室数据、并发症、残余肝体积（RLV）以及术后6个月的残余肝再生率（RLRR）。
LL组术后总胆红素（TB）、凝血酶原时间（PT）以及重症监护病房（ICU）停留时间低于RL组（P <.05）。LL组术后6个月的再生率并不显著高于RL组。然而，主要RHV组和LLS组的RLRR显著高于RL组（分别为89.2%对86%以及95.1%对86%，P <.05），但主要MHV组无显著差异。
总之，残余肝移植物不同的肝静脉引流模式可能影响LL LDLT中的再生率，尤其是主要RHV供体，其结局可能与RL更具可比性，应成为供体选择期间的一个有利选择。
