Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
5
pubmed:dateCreated
2010-5-4
pubmed:abstractText
The incidence of clinically significant right hepatic vein (RHV) stenosis after adult living donor liver transplantation has been higher than expected. In this study, an assessment of the risk factors for the development of RHV stenosis in this context was undertaken. Hepatic anatomy, surgical techniques, and the incidence of RHV stenosis 1 year after transplantation were evaluated retrospectively in 225 recipients of right lobe grafts. These patients underwent independent RHV reconstruction, which was facilitated by the application of computed tomography morphometry and computational simulation analyses. Three types of preparation of the orifice of the graft RHV and 7 types of preparation for venoplasty of the recipient RHV were used. The frequency of high, middle, and low sites of RHV insertion into the inferior vena cava (IVC) was 56.0%, 36.4%, and 7.6%, respectively, for donors, and 26.7%, 58.7%, and 14.7%, respectively, for recipients. Nine patients (4%) developed RHV stenosis of early onset that required stent insertion during the first 2 postoperative weeks; in 12 patients (5.3%), RHV stenosis of delayed onset occurred. Inappropriate matching of RHV sites of insertion correlated with the incidence of stenosis of early onset (P = 0.039). Technical refinements to avoid adverse consequences of inappropriate ventrodorsal matching of RHV sites of insertion include making the recipient RHV orifice wide and enlarging the recipient IVC by a customized incision and patch venoplasty after anatomical assessment of the RHV and IVC of the graft and recipient.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
May
pubmed:issn
1527-6473
pubmed:author
pubmed:copyrightInfo
2010 AASLD.
pubmed:issnType
Electronic
pubmed:volume
16
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
639-48
pubmed:meshHeading
pubmed-meshheading:20440773-Adult, pubmed-meshheading:20440773-Aged, pubmed-meshheading:20440773-Computer Simulation, pubmed-meshheading:20440773-Constriction, Pathologic, pubmed-meshheading:20440773-Female, pubmed-meshheading:20440773-Hepatic Veins, pubmed-meshheading:20440773-Humans, pubmed-meshheading:20440773-Incidence, pubmed-meshheading:20440773-Liver Circulation, pubmed-meshheading:20440773-Liver Transplantation, pubmed-meshheading:20440773-Living Donors, pubmed-meshheading:20440773-Male, pubmed-meshheading:20440773-Middle Aged, pubmed-meshheading:20440773-Models, Cardiovascular, pubmed-meshheading:20440773-Postoperative Complications, pubmed-meshheading:20440773-Reconstructive Surgical Procedures, pubmed-meshheading:20440773-Risk Factors, pubmed-meshheading:20440773-Vascular Patency, pubmed-meshheading:20440773-Vascular Surgical Procedures, pubmed-meshheading:20440773-Young Adult
pubmed:year
2010
pubmed:articleTitle
Morphometric and simulation analyses of right hepatic vein reconstruction in adult living donor liver transplantation using right lobe grafts.
pubmed:affiliation
Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't