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在实验台上对右叶移植物进行复杂重建:门静脉、肝前叶静脉、肝下静脉和多条胆管。

Complex Reconstruction of Right-Lobe Grafts on the Bench: Portal Vein, Anterior Sector Hepatic Veins, Inferior Hepatic Veins and Multiple Bile Ducts.

作者信息

Gupta Ankur A, Soin Arvinder S

机构信息

Institute of Liver Transplantation and Regenerative Medicine, Medanta the Medicity, Gurugram, India.

出版信息

J Clin Exp Hepatol. 2025 Jan-Feb;15(1):102411. doi: 10.1016/j.jceh.2024.102411. Epub 2024 Sep 14.

DOI:10.1016/j.jceh.2024.102411
PMID:39473448
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11513800/
Abstract

Living donor liver transplantation (LDLT) employing right-lobe (RL) grafts has become indispensable amid limited deceased donor graft availability. RL grafts, while smaller, offer outcomes comparable with deceased donor grafts, prompting a surge in global RL LDLT. However, bench surgery in LDLT requires meticulous preparation to minimize warm ischaemia time and ensure optimal inflow and outflow reconstruction. This review combines an analysis of existing literature with a discussion of our technique, emphasizing the intricacies of RL graft bench reconstruction.

摘要

在已故供体肝脏移植物供应有限的情况下,采用右叶(RL)移植物的活体供体肝移植(LDLT)已变得不可或缺。RL移植物虽然体积较小,但提供的结果与已故供体移植物相当,这促使全球RL LDLT数量激增。然而,LDLT中的离体手术需要精心准备,以尽量减少热缺血时间,并确保最佳的流入和流出道重建。本综述结合了对现有文献的分析以及对我们技术的讨论,强调了RL移植物离体重建的复杂性。

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Complex Reconstruction of Right-Lobe Grafts on the Bench: Portal Vein, Anterior Sector Hepatic Veins, Inferior Hepatic Veins and Multiple Bile Ducts.在实验台上对右叶移植物进行复杂重建:门静脉、肝前叶静脉、肝下静脉和多条胆管。
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Effect of Complex Venous Outflow Drainage Reconstruction on Postoperative Graft Function in Right-Lobe Living Donor Liver Transplantation.复杂静脉流出道重建对右半肝活体肝移植术后移植物功能的影响
J Clin Med. 2025 Mar 16;14(6):2005. doi: 10.3390/jcm14062005.

本文引用的文献

1
Single-Center Experience in Managing Right Liver Grafts From Trifurcation or Independent Right Posterior Portal Vein in Adult Living Donor Liver Transplantation.成人活体肝移植中处理来自三叉型或独立右后门静脉的右肝移植物的单中心经验
Transplant Proc. 2023 May;55(4):888-892. doi: 10.1016/j.transproceed.2023.03.047. Epub 2023 May 5.
2
Technical challenges in LDLT - Overcoming small for size syndrome and venous outflow reconstruction.活体肝移植中的技术挑战——克服小肝综合征和静脉流出道重建
Transplant Rev (Orlando). 2023 Jan;37(1):100750. doi: 10.1016/j.trre.2023.100750. Epub 2023 Feb 27.
3
Technical Refinement to Prevent Hepatic Outflow Disturbance in Right Lobe Living Donor Liver Transplantation: The New Simplified One-Orifice Venoplasty Technique.技术精细化以预防右半活体肝移植中肝流出道障碍:新简化单孔腔静脉吻合技术。
Transplant Proc. 2022 Oct;54(8):2230-2235. doi: 10.1016/j.transproceed.2022.08.037. Epub 2022 Oct 15.
4
Back Table Preparation of the Right Lobe Live Donor Liver Allograft: A Crucial Part of the Adult Live Donor Liver Transplant Procedure.右叶供体肝移植的背驮式准备:成人活体肝移植过程中的关键环节。
J Surg Res. 2022 Nov;279:796-802. doi: 10.1016/j.jss.2022.05.026. Epub 2022 Aug 17.
5
Long-term results of conjoined unification venoplasty for multiple portal vein branches of the right liver graft in living donor liver transplantations.活体肝移植中右肝移植多支门静脉联合统一静脉成形术的长期结果
Korean J Transplant. 2019 Dec 31;33(4):106-111. doi: 10.4285/jkstn.2019.33.4.106.
6
Middle hepatic vein reconstruction in adult living donor liver transplantation: a randomized clinical trial.成人活体肝移植中肝中静脉重建:一项随机临床试验。
Br J Surg. 2021 Dec 1;108(12):1426-1432. doi: 10.1093/bjs/znab346.
7
Venous outflow reconstruction using a polytetrafluoroethylene (PTFE) graft in right lobe living donor liver transplantation: A single center study.在右叶活体供肝移植中使用聚四氟乙烯(PTFE)移植物进行静脉流出道重建:一项单中心研究。
Surgery. 2021 Jun;169(6):1500-1509. doi: 10.1016/j.surg.2021.01.011. Epub 2021 Feb 26.
8
Single Orifice Outflow Reconstruction: Refining the Venous Outflow in Modified Right Lobe Live Donor Liver Transplantation.单孔流出道重建:改良右半活体肝移植中改良静脉流出道。
J Gastrointest Surg. 2021 Aug;25(8):1962-1972. doi: 10.1007/s11605-020-04776-3. Epub 2020 Aug 17.
9
Single Orifice Outflow Reconstruction in Various Tributaries of the Right Liver Graft Using Commercialized Polyethylene Terephthalate Y-graft: A technical Simplification of Venous Reconstruction in 3 Cases.使用商业化聚对苯二甲酸乙二酯Y型移植物对右肝移植物各分支进行单孔流出道重建:3例静脉重建的技术简化
Transplant Proc. 2020 Jul-Aug;52(6):1821-1824. doi: 10.1016/j.transproceed.2020.01.146. Epub 2020 May 21.
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Impact of the Reconstruction Material on the Patency of Middle Hepatic Vein in Living Donor Liver Transplantation Using the Right Liver.重建材料对活体供肝右半肝移植中肝静脉通畅性的影响
Transplant Proc. 2019 Oct;51(8):2745-2749. doi: 10.1016/j.transproceed.2019.03.075.