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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...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Society for Transplantation
2021
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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. |
format | Online Article Text |
id | pubmed-9235329 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | The Korean Society for Transplantation |
record_format | MEDLINE/PubMed |
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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