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Recipient liver splitting to facilitate piggyback hepatectomy in adult living donor liver transplantation

Recipient hepatectomy for an enlarged stony-hard liver is a demanding procedure, thus it is often accompanied by massive blood loss. Recipient liver splitting under prolonged hepatic inflow occlusion would facilitate the piggyback recipient hepatectomy. We herein present a case of recipient liver sp...

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Autores principales: Kim, Sung-Min, Hwang, Shin, Moon, Deok-Bog, Jung, Dong-Hwan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society for Transplantation 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9235329/
https://www.ncbi.nlm.nih.gov/pubmed/35769526
http://dx.doi.org/10.4285/kjt.20.0055
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author Kim, Sung-Min
Hwang, Shin
Moon, Deok-Bog
Jung, Dong-Hwan
author_facet Kim, Sung-Min
Hwang, Shin
Moon, Deok-Bog
Jung, Dong-Hwan
author_sort Kim, Sung-Min
collection PubMed
description Recipient hepatectomy for an enlarged stony-hard liver is a demanding procedure, thus it is often accompanied by massive blood loss. Recipient liver splitting under prolonged hepatic inflow occlusion would facilitate the piggyback recipient hepatectomy. We herein present a case of recipient liver splitting, which was used for living donor liver transplantation (LDLT). A 48-year-old male patient diagnosed with acute-on-chronic liver failure underwent LDLT. During the recipient operation, the native liver was stony-hard and heavily adherent to the retrohepatic inferior vena cava (IVC). During liver mobilization, diffuse oozing occurred due to disseminated intravascular coagulation. As a change in the concept, we decided to perform in situ liver splitting of the recipient liver to facilitate dissection of the retrohepatic IVC. Under hepatic inflow occlusion, right-left liver splitting was performed along the usual plane of extended left hepatectomy. The procedures time for recipient liver splitting and removal was 60 minutes. A modified right liver graft recovered from his daughter was implanted according to the standard procedures of LDLT. We think that recipient liver splitting is a feasible technical option for coping with difficult recipient hepatectomy, especially in patients with an enlarged stony-hard liver and heavy adhesion around the IVC.
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spelling pubmed-92353292022-06-28 Recipient liver splitting to facilitate piggyback hepatectomy in adult living donor liver transplantation Kim, Sung-Min Hwang, Shin Moon, Deok-Bog Jung, Dong-Hwan Korean J Transplant Case Report Recipient hepatectomy for an enlarged stony-hard liver is a demanding procedure, thus it is often accompanied by massive blood loss. Recipient liver splitting under prolonged hepatic inflow occlusion would facilitate the piggyback recipient hepatectomy. We herein present a case of recipient liver splitting, which was used for living donor liver transplantation (LDLT). A 48-year-old male patient diagnosed with acute-on-chronic liver failure underwent LDLT. During the recipient operation, the native liver was stony-hard and heavily adherent to the retrohepatic inferior vena cava (IVC). During liver mobilization, diffuse oozing occurred due to disseminated intravascular coagulation. As a change in the concept, we decided to perform in situ liver splitting of the recipient liver to facilitate dissection of the retrohepatic IVC. Under hepatic inflow occlusion, right-left liver splitting was performed along the usual plane of extended left hepatectomy. The procedures time for recipient liver splitting and removal was 60 minutes. A modified right liver graft recovered from his daughter was implanted according to the standard procedures of LDLT. We think that recipient liver splitting is a feasible technical option for coping with difficult recipient hepatectomy, especially in patients with an enlarged stony-hard liver and heavy adhesion around the IVC. The Korean Society for Transplantation 2021-06-30 2021-05-10 /pmc/articles/PMC9235329/ /pubmed/35769526 http://dx.doi.org/10.4285/kjt.20.0055 Text en Copyright © 2021 The Korean Society for Transplantation https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Kim, Sung-Min
Hwang, Shin
Moon, Deok-Bog
Jung, Dong-Hwan
Recipient liver splitting to facilitate piggyback hepatectomy in adult living donor liver transplantation
title Recipient liver splitting to facilitate piggyback hepatectomy in adult living donor liver transplantation
title_full Recipient liver splitting to facilitate piggyback hepatectomy in adult living donor liver transplantation
title_fullStr Recipient liver splitting to facilitate piggyback hepatectomy in adult living donor liver transplantation
title_full_unstemmed Recipient liver splitting to facilitate piggyback hepatectomy in adult living donor liver transplantation
title_short Recipient liver splitting to facilitate piggyback hepatectomy in adult living donor liver transplantation
title_sort recipient liver splitting to facilitate piggyback hepatectomy in adult living donor liver transplantation
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9235329/
https://www.ncbi.nlm.nih.gov/pubmed/35769526
http://dx.doi.org/10.4285/kjt.20.0055
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