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An Alternative Surgical Technique of Native Hepatectomy in Liver Transplantation
BACKGROUND: Orthotopic liver transplantation has become the procedure of choice for end-stage liver disease. There are 3 commonly used methods of vena cava anastomosis. Here, we report a new technique for native hepatectomy. MATERIAL/METHODS: The data of 12 patients who underwent orthotopic liver tr...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
International Scientific Literature, Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7999712/ https://www.ncbi.nlm.nih.gov/pubmed/33753713 http://dx.doi.org/10.12659/AOT.929259 |
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author | Chen, Maogen Ju, Weiqiang Lin, Xiaohong Chen, Yinghua Zhao, Qiang Guo, Zhiyong He, Xiaoshun Wang, Dongping |
author_facet | Chen, Maogen Ju, Weiqiang Lin, Xiaohong Chen, Yinghua Zhao, Qiang Guo, Zhiyong He, Xiaoshun Wang, Dongping |
author_sort | Chen, Maogen |
collection | PubMed |
description | BACKGROUND: Orthotopic liver transplantation has become the procedure of choice for end-stage liver disease. There are 3 commonly used methods of vena cava anastomosis. Here, we report a new technique for native hepatectomy. MATERIAL/METHODS: The data of 12 patients who underwent orthotopic liver transplantation using a new surgical technique were retrospectively collected for analysis. The new separation and reconstruction surgical technique mainly involved the second portal isolation and hepatectomy that followed. We performed recipient liver resection without the occlusion of the inferior vena cava, which was then followed by classic, piggyback, modified piggyback, or side-to-side orthotopic liver transplantation. The graft function index and complications were collected after transplantation. RESULTS: The length of the anhepatic phase was 30.92±9.1 min. Alanine transaminase (ALT) levels were 138 to 2027 U/L, with a median of 361.5 U/L. The ALT levels of all patients gradually decreased to normal levels 7 to 10 days after surgery. Only 2 recipients had elevated levels of ALT higher than 1000 U/L. Four of 12 patients did not require red blood cell transfusion during surgery. Four patients appeared to have early allograft dysfunction, while others recovered smoothly. CONCLUSIONS: This new surgical technique may shorten the anhepatic phase and decrease blood loss volume, aiding the success of liver transplant surgery. It can be used for most patients and does not increase the risk of complications or impair prognosis. |
format | Online Article Text |
id | pubmed-7999712 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | International Scientific Literature, Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-79997122021-04-01 An Alternative Surgical Technique of Native Hepatectomy in Liver Transplantation Chen, Maogen Ju, Weiqiang Lin, Xiaohong Chen, Yinghua Zhao, Qiang Guo, Zhiyong He, Xiaoshun Wang, Dongping Ann Transplant Original Paper BACKGROUND: Orthotopic liver transplantation has become the procedure of choice for end-stage liver disease. There are 3 commonly used methods of vena cava anastomosis. Here, we report a new technique for native hepatectomy. MATERIAL/METHODS: The data of 12 patients who underwent orthotopic liver transplantation using a new surgical technique were retrospectively collected for analysis. The new separation and reconstruction surgical technique mainly involved the second portal isolation and hepatectomy that followed. We performed recipient liver resection without the occlusion of the inferior vena cava, which was then followed by classic, piggyback, modified piggyback, or side-to-side orthotopic liver transplantation. The graft function index and complications were collected after transplantation. RESULTS: The length of the anhepatic phase was 30.92±9.1 min. Alanine transaminase (ALT) levels were 138 to 2027 U/L, with a median of 361.5 U/L. The ALT levels of all patients gradually decreased to normal levels 7 to 10 days after surgery. Only 2 recipients had elevated levels of ALT higher than 1000 U/L. Four of 12 patients did not require red blood cell transfusion during surgery. Four patients appeared to have early allograft dysfunction, while others recovered smoothly. CONCLUSIONS: This new surgical technique may shorten the anhepatic phase and decrease blood loss volume, aiding the success of liver transplant surgery. It can be used for most patients and does not increase the risk of complications or impair prognosis. International Scientific Literature, Inc. 2021-03-23 /pmc/articles/PMC7999712/ /pubmed/33753713 http://dx.doi.org/10.12659/AOT.929259 Text en © Ann Transplant, 2021 This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) ) |
spellingShingle | Original Paper Chen, Maogen Ju, Weiqiang Lin, Xiaohong Chen, Yinghua Zhao, Qiang Guo, Zhiyong He, Xiaoshun Wang, Dongping An Alternative Surgical Technique of Native Hepatectomy in Liver Transplantation |
title | An Alternative Surgical Technique of Native Hepatectomy in Liver Transplantation |
title_full | An Alternative Surgical Technique of Native Hepatectomy in Liver Transplantation |
title_fullStr | An Alternative Surgical Technique of Native Hepatectomy in Liver Transplantation |
title_full_unstemmed | An Alternative Surgical Technique of Native Hepatectomy in Liver Transplantation |
title_short | An Alternative Surgical Technique of Native Hepatectomy in Liver Transplantation |
title_sort | alternative surgical technique of native hepatectomy in liver transplantation |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7999712/ https://www.ncbi.nlm.nih.gov/pubmed/33753713 http://dx.doi.org/10.12659/AOT.929259 |
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