KLI

Fates of retained hepatic segment IV and its prognostic impact in adult split liver transplantation using an extended right liver graft

Metadata Downloads
Abstract
Purpose: When splitting a liver for adult and pediatric graft recipients, the retained left medial section (S4) will undergo ischemic necrosis and the right trisection graft becomes an extended right liver (ERL) graft. We investigated the fates of the retained S4 and its prognostic impact in adult split liver transplantation (SLT) using an ERL graft.

Methods: This was a retrospective analysis of 25 adult SLT recipients who received split ERL grafts.

Results: The mean model for end-stage liver disease (MELD) score was 27.3 +/- 10.9 and graft-recipient weight ratio (GRWR) was 1.98 +/- 0.44. The mean donor age was 26.5 +/- 7.7 years. The split ERL graft weight was 1,181.5 +/- 252.8 g, which resulted in a mean GRWR of 1.98 +/- 0.44. Computed tomography of the retained S4 parenchyma revealed small ischemic necrosis in 16 patients (64.0%) and large ischemic necrosis in the remaining 9 patients (36.0%). No S4-associated biliary complications were developed. The mean GRWR was 1.87 +/- 0.43 in the 9 patients with large ischemic necrosis and 2.10 +/- 0.44 in the 15 cases with small ischemic necrosis (P = 0.283). The retained S4 parenchyma showed gradual atrophy on follow-up imaging studies. The amount of S4 ischemic necrosis was not associated with graft (P = 0.592) or patient (P = 0.243) survival. A MELD score of >30 and pretransplant ventilator support were associated with inferior outcomes.

Conclusion: The amount of S4 ischemic necrosis is not a prognostic factor in adult SLT recipients, probably due to a sufficiently large GRWR.
Author(s)
강우형김기훈김민재김상훈나병곤문덕복박길춘송기원안철수윤영이이승규정동환정용규조회동최진욱하태용황신
Issued Date
2021
Type
Article
Keyword
Deceased donorDonor shortageExtended right liver graftLeft medial segmentOriginalWhole liver graft
DOI
10.4174/astr.2021.101.1.37
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8537
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8255581&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Fates%20of%20retained%20hepatic%20segment%20IV%20and%20its%20prognostic%20impact%20in%20adult%20split%20liver%20transplantation%20using%20an%20extended%20right%20liver%20graft&offset=0&pcAvailability=true
Publisher
ANNALS OF SURGICAL TREATMENT AND RESEARCH
Location
대한민국
Language
영어
ISSN
2288-6575
Citation Volume
101
Citation Number
1
Citation Start Page
37
Citation End Page
48
Appears in Collections:
Medicine > Medicine
Authorize & License
  • Authorize공개
Files in This Item:
  • There are no files associated with this item.

Items in Repository are protected by copyright, with all rights reserved, unless otherwise indicated.