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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...

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Autores principales: Chen, Maogen, Ju, Weiqiang, Lin, Xiaohong, Chen, Yinghua, Zhao, Qiang, Guo, Zhiyong, He, Xiaoshun, Wang, Dongping
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2021
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.
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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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