Use of 3-dimensional computed hepatic venous visualization for graft outflow venoplasty in adult left living-donor liver transplant.

نویسندگان

  • Taizen Urahashi
  • Hideo Katsuragawa
  • Masakazu Yamamoto
  • Yoshiyuki Ihara
  • Yukihiro Sanada
  • Taiichi Wakiya
  • Koichi Mizuta
چکیده

OBJECTIVES A surgeon must be aware of hepatic vascular variations to safely perform living-donor liver transplant. The ramification patterns of the hepatic veins with tributaries for left lobe graft outflow venoplasty should be evaluated preoperatively with 3-dimensional computed tomography of the donor. MATERIALS AND METHODS Twenty-four potential donors were examined between October 1999 and July 2006 for living-donor liver transplant using the left lobe. They underwent triphasic helical computed tomography of the liver on a multidetector helical computed tomographic scanner. All images, including 2-dimensional reformation and 3-dimensional reconstructed models with maximum intensity projection and volume rendering, were sent to a workstation for postprocessing. RESULTS The ramification patterns of the left and middle hepatic vein were classified into 2 groups; they formed a common trunk (type 1), which had 3 variations; type 1A (13 cases): in which the left hepatic vein and the middle hepatic vein without any tributaries on their confluence; type 1B (8 cases): in which there was venous confluence in the left hepatic vein with the left superficial vein and middle hepatic vein; type 1C (2 cases): in which the hepatic venous confluence in the left hepatic vein and middle hepatic vein and the left superficial vein directly joining into the inferior vena cava; type 2 (1 case) had the left hepatic vein and middle hepatic vein joining into the inferior vena cava separately; type 1B underwent 2 venoplasty procedures, but the others underwent only a single venoplasty. CONCLUSIONS We demonstrated the anatomic interrelation of the hepatic veins for hepatic outflow venoplasty of adult left lobe living-donor liver transplant with 3-dimensional computed tomography scanning to help surgeons preoperatively determine the appropriate technique or form of reconstruction.

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عنوان ژورنال:
  • Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation

دوره 10 4  شماره 

صفحات  -

تاریخ انتشار 2012