Ankara University School of Medicine, Department of Surgery, Ankara Universitesi Tip Fakultesi Ibni Sina Hastanesi Akademik Yerleske K-4 Sıhhiye, Ankara, Turkey.
Ankara University School of Medicine, Department of Surgery, Ankara Universitesi Tip Fakultesi Ibni Sina Hastanesi Akademik Yerleske K-4 Sıhhiye, Ankara, Turkey.
Hepatobiliary Pancreat Dis Int. 2020 Aug;19(4):318-323. doi: 10.1016/j.hbpd.2020.07.002. Epub 2020 Jul 10.
Right lobe living donor liver transplantation (LDLT) is a major development in adult LDLT that has significantly increased the donor pool by providing larger graft size and by decreasing risk of small-for-size graft syndrome. However, right lobe anatomy is complex, not only from the inflow but also from the outflow perspective. Outflow reconstruction is one of the key requirements of a successful LDLT and venous drainage of the liver graft is just as important as hepatic inflow for the integrity of graft function. Outflow complications may cause acute graft failure which is not always easy to diagnose. The right lobe graft consists of two sections and three hepatic venous routes for drainage that require reconstruction. In order to obtain a congestion free graft, several types of vascular conduits and postoperative interventions are needed to assure an adequate venous allograft drainage. This review described the anatomy, functional basis and the evolution of outflow reconstruction in right lobe LDLT.
右半肝活体肝移植（LDLT）是成人 LDLT 的一项重大发展，通过提供更大的移植物尺寸和降低小肝综合征的风险，显著增加了供体库。然而，右半肝解剖结构复杂，不仅从流入方面，而且从流出方面来看都是如此。流出重建是成功 LDLT 的关键要求之一，肝移植物的静脉引流与肝流入一样重要，对于移植物功能的完整性至关重要。流出并发症可能导致急性移植物失功，而这并不总是容易诊断的。右半肝移植物由两部分和三条肝静脉途径组成，需要进行重建以实现无充血的移植物。为了获得无充血的移植物，需要使用几种类型的血管移植物和术后干预措施来确保静脉同种异体移植物的充分引流。本综述描述了右半肝 LDLT 中流出重建的解剖学、功能基础和演变。
