IV segment portal vein reconstruction in split-liver transplantation with extended right grafts

• Published in: BMC surgery Vol. 22; no. 1; pp. 1 - 8
• Main Authors: Wang, Dong, Fan, Ning, Wang, Xin, Sun, Yandong, Guan, Ge, Wang, Jianhong, Zhu, Xiaodan, Zang, Yunjin, Cai, Jinzhen, Guo, Yuan
• Format: Journal Article
• Language: English
• Published: London BioMed Central Ltd 11.08.2022; BioMed Central; BMC
• Subjects: Adults; Albumins; Analysis; Bile ducts; Blood vessels; Body mass index; Care and treatment; Complications; Creatinine; Flow velocity; Grafting; Ischemia; IV segment; Liver; Liver diseases; Liver transplantation; Liver transplants; Medical research; Medicine, Experimental; P4 reconstruction; Patients; Pediatrics; Portal vein; Postoperative; Recovery; Segments; Software; Split liver transplantation; Surgery; Transplantation; Transplants & implants; Ultrasonic imaging; Veins & arteries
• DOI: 10.1186/s12893-022-01761-2
• ISSN: 1471-2482

Background Liver transplantation is one of the most effective treatments for end-stage liver disease. Split liver transplantation (SLT) can effectively improve the utilization efficiency of grafts. However, split liver transplantation still faces shortcomings and is not widely used in surgery. How to improve the effective transplantation volume of split liver transplantation and promote the postoperative recovery of patients has important clinical significance. Methods In our study, the donor's liver was split into the extended right graft and left lateral sector, and the IV segment occur ischemia. To guarantee the functional graft size, and avoid complications, we reconstructed the IV segment portal vein and left portal vein. And we analyzed the operation time, intraoperative bleeding, liver function, and postoperative complications. Results In our research, 14 patients underwent IV segment portal vein reconstruction, and 8 patients did not undergo vascular reconstruction. We found that the ischemic area of the IV segment decreased significantly after IV segment portal vein reconstruction. We found that there was no significant difference in operation time and postoperative complications between the patients of the groups. There were significant differences in ALT on the 1st day and albumin on the 6th day after the operation. Conclusion It indicates that IV segment reconstruction in SLT surgery can alleviate the graft ischemic and promote the recovery of liver function after the operation. And, IV segment reconstruction as a novel operating procedure may be widely used in SLT. Keywords: Split liver transplantation, IV segment, Ischemia, P4 reconstruction