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Feasibility and outcomes of living-donor liver transplantation utilizing the right hemi-liver graft with portal vein anatomical variations
PURPOSE: Portal vein (PV) reconstruction is a key factor for successful living-donor liver transplantation (LDLT). Anatomical variations of right PV (RPV) are encountered among potential donors. METHODS: To evaluate a single center experience of reconstruction techniques for the right hemi-liver gra...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10550851/ https://www.ncbi.nlm.nih.gov/pubmed/37792043 http://dx.doi.org/10.1007/s00423-023-03115-9 |
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author | Shehta, Ahmed Elshobari, Mohamed Salah, Tarek Sultan, Ahmad M. Yasen, Amr Shiha, Usama El-Saadany, Mohamed Monier, Ahmed Said, Rami Habl, Mohamed S. Adly, Reham El Ged, Basma Abd Elmoaem Karam, Rasha Khaled, Reem El Razek, Hassan Magdy Abd Abdel-Khalek, Ehab E. Wahab, Mohamed Abdel |
author_facet | Shehta, Ahmed Elshobari, Mohamed Salah, Tarek Sultan, Ahmad M. Yasen, Amr Shiha, Usama El-Saadany, Mohamed Monier, Ahmed Said, Rami Habl, Mohamed S. Adly, Reham El Ged, Basma Abd Elmoaem Karam, Rasha Khaled, Reem El Razek, Hassan Magdy Abd Abdel-Khalek, Ehab E. Wahab, Mohamed Abdel |
author_sort | Shehta, Ahmed |
collection | PubMed |
description | PURPOSE: Portal vein (PV) reconstruction is a key factor for successful living-donor liver transplantation (LDLT). Anatomical variations of right PV (RPV) are encountered among potential donors. METHODS: To evaluate a single center experience of reconstruction techniques for the right hemi-liver grafts with PV variations during the period between May 2004 and 2022. RESULTS: A total of 915 recipients underwent LDLT, among them 52 (5.8%) had RPV anatomical variations. Type II PV was found in 7 cases (13.5%), which were reconstructed by direct venoplasty. Type III PV was found in 27 cases (51.9%). They were reconstructed by direct venoplasty in 2 cases (3.8%), Y graft interposition in 2 cases (3.8%), and in situ double PV anastomoses in 23 cases (44.2%). Type IV PV was found in 18 cases (34.6%) and was reconstructed by Y graft interposition in 9 cases (17.3%), and in situ double PV anastomoses in 9 cases (17.3%). Early right posterior PV stenosis occurred in 2 recipients (3.8%). Early PV thrombosis occurred in 3 recipients (5.8%). The median follow-up duration was 54.5 months (4 – 185). The 1-, 3-, and 5-years survival rates were 91.9%, 86%, and 81.2%, respectively. Late PV stenosis occurred in 2 recipients (3.8%) and was managed conservatively. CONCLUSION: Utilization of potential living donors with RPV anatomic variations may help to expand the donor pool. We found that direct venoplasty and in situ dual PV anastomoses techniques were safe, feasible, and associated with successful outcomes. |
format | Online Article Text |
id | pubmed-10550851 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-105508512023-10-06 Feasibility and outcomes of living-donor liver transplantation utilizing the right hemi-liver graft with portal vein anatomical variations Shehta, Ahmed Elshobari, Mohamed Salah, Tarek Sultan, Ahmad M. Yasen, Amr Shiha, Usama El-Saadany, Mohamed Monier, Ahmed Said, Rami Habl, Mohamed S. Adly, Reham El Ged, Basma Abd Elmoaem Karam, Rasha Khaled, Reem El Razek, Hassan Magdy Abd Abdel-Khalek, Ehab E. Wahab, Mohamed Abdel Langenbecks Arch Surg Research PURPOSE: Portal vein (PV) reconstruction is a key factor for successful living-donor liver transplantation (LDLT). Anatomical variations of right PV (RPV) are encountered among potential donors. METHODS: To evaluate a single center experience of reconstruction techniques for the right hemi-liver grafts with PV variations during the period between May 2004 and 2022. RESULTS: A total of 915 recipients underwent LDLT, among them 52 (5.8%) had RPV anatomical variations. Type II PV was found in 7 cases (13.5%), which were reconstructed by direct venoplasty. Type III PV was found in 27 cases (51.9%). They were reconstructed by direct venoplasty in 2 cases (3.8%), Y graft interposition in 2 cases (3.8%), and in situ double PV anastomoses in 23 cases (44.2%). Type IV PV was found in 18 cases (34.6%) and was reconstructed by Y graft interposition in 9 cases (17.3%), and in situ double PV anastomoses in 9 cases (17.3%). Early right posterior PV stenosis occurred in 2 recipients (3.8%). Early PV thrombosis occurred in 3 recipients (5.8%). The median follow-up duration was 54.5 months (4 – 185). The 1-, 3-, and 5-years survival rates were 91.9%, 86%, and 81.2%, respectively. Late PV stenosis occurred in 2 recipients (3.8%) and was managed conservatively. CONCLUSION: Utilization of potential living donors with RPV anatomic variations may help to expand the donor pool. We found that direct venoplasty and in situ dual PV anastomoses techniques were safe, feasible, and associated with successful outcomes. Springer Berlin Heidelberg 2023-10-04 2023 /pmc/articles/PMC10550851/ /pubmed/37792043 http://dx.doi.org/10.1007/s00423-023-03115-9 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Research Shehta, Ahmed Elshobari, Mohamed Salah, Tarek Sultan, Ahmad M. Yasen, Amr Shiha, Usama El-Saadany, Mohamed Monier, Ahmed Said, Rami Habl, Mohamed S. Adly, Reham El Ged, Basma Abd Elmoaem Karam, Rasha Khaled, Reem El Razek, Hassan Magdy Abd Abdel-Khalek, Ehab E. Wahab, Mohamed Abdel Feasibility and outcomes of living-donor liver transplantation utilizing the right hemi-liver graft with portal vein anatomical variations |
title | Feasibility and outcomes of living-donor liver transplantation utilizing the right hemi-liver graft with portal vein anatomical variations |
title_full | Feasibility and outcomes of living-donor liver transplantation utilizing the right hemi-liver graft with portal vein anatomical variations |
title_fullStr | Feasibility and outcomes of living-donor liver transplantation utilizing the right hemi-liver graft with portal vein anatomical variations |
title_full_unstemmed | Feasibility and outcomes of living-donor liver transplantation utilizing the right hemi-liver graft with portal vein anatomical variations |
title_short | Feasibility and outcomes of living-donor liver transplantation utilizing the right hemi-liver graft with portal vein anatomical variations |
title_sort | feasibility and outcomes of living-donor liver transplantation utilizing the right hemi-liver graft with portal vein anatomical variations |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10550851/ https://www.ncbi.nlm.nih.gov/pubmed/37792043 http://dx.doi.org/10.1007/s00423-023-03115-9 |
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