Assessment of Technical Feasibility of Living Donor Liver Transplantation after Prior Major Liver Resection for Hepatocellular Carcinoma.
- Author:
Tae Young KIM
1
;
Shin HWANG
;
Sung Gyu LEE
;
Deok Bog MOON
;
Chul Soo AHN
;
Ki Hun KIM
;
Kwang Min PARK
;
Young Joo LEE
;
Tae Yong HA
;
Gi Won SONG
;
Dong Hwan JUNG
;
Bum Soo KIM
;
Ki Myung MOON
Author Information
1. Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. sglee2@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Salvage liver transplantation;
Living donor liver transplantation;
Hepatocellular carcinoma
- MeSH:
Bile Ducts;
Carcinoma, Hepatocellular*;
Hepatectomy;
Hepatic Artery;
Hepatic Veins;
Humans;
Liver Transplantation*;
Liver*;
Living Donors*;
Portal Vein;
Transplants;
Vena Cava, Inferior
- From:The Journal of the Korean Society for Transplantation
2006;20(2):227-233
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose: Liver transplantation has been performed for recurrent hepatocellular carcinoma (HCC) or deterioration of liver function after prior primary liver resection. Prior major liver resection per se is an unfavorable condition for living donor liver transplantation (LDLT). We analyzed the technical feasibility of prior major hepatectomy-graft combinations for salvage LDLT. Methods: Of the 17 patients who underwent salvage LDLT, 5 underwent prior major liver resection. Results: Two patients with prior left lobectomy received right lobe graft, whereas, of the 3 patients with prior right lobectomy, 2 received right lobe graft and 1 received left lobe graft. During recipient hepatectomy, it was necessary to perform meticulous sharp dissection of the previous liver cut surface to attain full mobilization. Different methods of hepatic vein reconstruction were applied after the recipient inferior vena cava was fully dissected. Reconstruction of the portal vein, hepatic artery and bile duct were performed on case by case basis depending on the remnant hilar structures. Conclusion: In conclusion, every combination of recipient prior right or left lobectomy and living donor right or left liver graft seems to be feasible for salvage LDLT.
