右叶活体肝移植中，供体门静脉修复肝中静脉-结果分析。

Explant portal vein for reconstructing middle hepatic vein in right lobe living donor liver transplantation-outcome analysis.

机构信息

Department of Liver Transplantation and Hepato Pancreatico Biliary Surgery, Institute of Liver and Biliary Sciences, New Delhi, India.

出版信息

HPB (Oxford). 2018 Dec;20(12):1137-1144. doi: 10.1016/j.hpb.2018.05.008. Epub 2018 Jun 27.

DOI:10.1016/j.hpb.2018.05.008

PMID:29958810

Abstract

BACKGROUND

The aim of the study was to study the four week patency rates of the reconstructed neo middle hepatic vein specifically using the explant portal vein (PV) in right hemiliver live donor liver transplantation (LDLT). We hypothesized that short term patency of the neo-MHV should result in good graft and patient outcomes.

METHODS

Pre, intra and post operative variables were prospectively collected for 88 consecutive patients undergoing right hemiliver LDLT from January 2014 to October 2015.

RESULTS

Explant PV was used to reconstruct neo-MHV in 76 (86.4%, 76/88) patients. Neo MHV patency rate at 28 days with explant PV was 89.4% (59/66) and with other conduit (PTFE) was 90.9% (10/11). All occlusions were detected after 7 days. There was no impact of the patency of the neo-MHV on the incidence of early allograft dysfunction, sepsis, rejection, morbidity or mortality, despite the contribution of the anterior sector to the graft volume being more than 50% in close to two-thirds of patients.

CONCLUSION

The reconstructed neo-MHV has excellent short term patency rates at 4 weeks. Perhaps due to the absence of early occlusions, there was no impact on graft or patient outcomes in the study population.

摘要

背景

本研究旨在研究使用右半肝供肝的离体门静脉（PV）重建新的中肝静脉（MHV）的 4 周通畅率，用于右半肝活体肝移植（LDLT）。我们假设新 MHV 的短期通畅率应该导致良好的移植物和患者预后。

方法

前瞻性收集 2014 年 1 月至 2015 年 10 月连续 88 例接受右半肝 LDLT 的患者的术前、术中及术后变量。

结果

76 例（86.4%，76/88）患者采用离体 PV 重建新的 MHV。使用离体 PV 的新 MHV 28 天通畅率为 89.4%（59/66），使用其他移植物（PTFE）的通畅率为 90.9%（10/11）。所有闭塞均发生在术后 7 天后。尽管近三分之二的患者的供体前区体积超过了 50%，但新 MHV 的通畅率对早期移植物功能障碍、脓毒症、排斥反应、发病率或死亡率的发生率没有影响。