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Chapter-07 Graft Volume Estimation and Donor with Fatty Liver

BOOK TITLE: Liver Transplantation

Author
1. K Dilip Chakravarty
2. Lee WC
3. Jan YY
4. Lee Po-Huang
ISBN
9788184487701
DOI
10.5005/jp/books/10445_7
Edition
1/e
Publishing Year
2010
Pages
4
Author Affiliations
1. Chang Gung Memorial Hospital (Linkou), Taipei, Taiwan (ROC)
2. Chang Gung Transplantation Institute (Linkou), Chang Gung University, Taipei, Taiwan (ROC)
3. Chang Gung Memorial Hospital (Linkou), Chang Gung University, Taipei, Taiwan (ROC)
4. National Taiwan University Hospital, Taipei, Taiwan (ROC)
Chapter keywords

Abstract

In living donor liver transplantation (LDLT), the size of the graft is a major concern for both donor and recipient safety. Small for size graft (<0.6% – 0.8%) causes graft dysfunction and other life threatening complications. Conversely, large for size grafts (>5%) may be associated with anatomical, immunological disadvantages and graft necrosis; however, their negative impact is less pronounced. In recipient, an adequate graft volume is necessary to satisfy the metabolic demands of the recipient. The residual liver volume in the donor must be sufficient for postoperative liver regeneration and metabolic needs. During graft harvesting of LDLT, it should be determined on which side of the donor liver, the middle hepatic vein should be preserved to avoid congestion of parenchyma. The congestive area in the right liver graft does not function well immediately after transplantation. Presence of fatty change in a live donor is a major concern, affecting the post-transplantation graft dysfunction. Severe steatosis of the liver graft places the recipient at risk for PNF in DDLT. Therefore, an accurate preoperative estimation of the volume should be mandatory for LDLT.

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