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01-11-2014 | Original Article

Three-dimensional computed tomography analysis of variations in the middle hepatic vein tributaries: proposed new classification

Authors: Hiroto Kayashima, Ken Shirabe, Rumi Matono, Shohei Yoshiya, Kazutoyo Morita, Kenji Umeda, Toru Ikegami, Tomoharu Yoshizumi, Yuji Soejima, Yoshihiko Maehara

Published in: Surgery Today | Issue 11/2014

Abstract

Purpose

To evaluate the anatomical variations in the middle hepatic vein tributaries (V5/V8) for determining the reconstruction strategy in right lobe living donor liver transplantation (LDLT).

Methods

The V5/V8 variations were examined in 268 patients and were classified into three and two types, respectively. The reconstruction rate (RR), patency rate (PR) and clinical outcomes were retrospectively evaluated in 46 right lobe LDLT cases.

Results

In terms of V5 variations, the RR and PR were significantly higher for type 2 than type 3 (82.6 vs. 44.4 % and 73.7 vs. 25.0 %, respectively). The alanine aminotransferase level on postoperative day (POD) 5 in the V5 patent group was significantly lower than in the occluded group (123 vs. 191 IU/dL). Regarding V8 variations, the RR and PR were significantly higher for type 1 than type 2 (44.4 vs. 17.6 % and 75.0 vs. 33.3 %, respectively). The aspartate aminotransferase level on POD 3 was significantly lower in the V8 patent group than in the occluded group (50 vs. 121 IU/dL).

Conclusion

For right lobe grafts with single large V5 (type 2) or V8 (type 1) variations, reconstruction is necessary. Our new classification of the MHV tributaries is useful for determining the reconstruction strategy to use in right lobe LDLT.

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Title: Three-dimensional computed tomography analysis of variations in the middle hepatic vein tributaries: proposed new classification
Authors: Hiroto Kayashima
Ken Shirabe
Rumi Matono
Shohei Yoshiya
Kazutoyo Morita
Kenji Umeda
Toru Ikegami
Tomoharu Yoshizumi
Yuji Soejima
Yoshihiko Maehara
Publication date: 01-11-2014
Publisher: Springer Japan
Published in: Surgery Today / Issue 11/2014
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI: https://doi.org/10.1007/s00595-014-0836-1

At a glance: The STEP trials

Springer Medicine

Three-dimensional computed tomography analysis of variations in the middle hepatic vein tributaries: proposed new classification

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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