Portal Vein Complication After Living Donor Right Hepatectomy.

D.-H. Jung, S.-G. Lee, S. Hwang, K.-H. Kim, C.-S. Ahn, D.-B. Moon, T.-Y. Ha, G.-W. Song, W.-J. Kim, S.-H. Kim, W.-H. Kang, J.-H. Kwon, E.-K. Jwa, H.-D. Cho.

Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

Meeting: 2016 American Transplant Congress

Abstract number: A204

Keywords: Liver transplantation, Living-related liver donors, Radiologic assessment, Surgical complications

Session Information

Session Name: Poster Session A: Living Donor Liver Transplantation

Session Type: Poster Session

Date: Saturday, June 11, 2016

Session Time: 5:30pm-7:30pm

Presentation Time: 5:30pm-7:30pm

Location: Halls C&D

Background

Living donor hepatectomy may carry a significant risk of morbidity and mortality for the otherwise healthy donor. Portal vein (PV) complication after donor hepatectomy is rare but cause severe sequelae without proper management. This study intended to assess incidence and treatment of portal vein (PV) complication after living donor right hepatectomy.

Methods

This study analyzed 2997 cases of living donor right hepatectomy from July 1997 to December 2014 at Asan Medical Center regarding on portal vein complication.

Results

Male and female were 2072 (69.1%) and 925 (30.9%), respectively. Mean donor age was 27.5±8.1 years old. Mean body mass index was 22.67±2.75. Type 1, 2, 3, and 4 PV anomaly were 2769 (92.4%), 99 (3.3%), 127 (4.2%), and 2 (0.1%), respectively. PV stenosis (>50% narrowing of PV diatmeter) occurred 19 cases (0.6%). Incidence of PV stenosis was occurred in 0.3% in type 1, 3% in type 2, 5.5% in type 3, and 0% in type4 (P<0.001). Among 19 PV stenosis donors, PV stent insertion was performed in 7 cases (0.2%) which occurred 2 in type 1 (0.1%), 0 in type 2 (0%), 5 in type 3 (3.9%), and 0 in type 4 (0%) (P<0.001). One patient with type 3 PV anomaly who performed end to end anastomosis of PV to make one orifice in graft side PV during donor right hepatectomy intra-operatively inserted PV stent at post-operative 2 days due to PV thrombosis and stenosis. Other 6 patients who inserted PV stent underwent the procedures percutaneously from postoperative 16 to 70 days. All PV complication donors had no long-term sequelae and are alive.

Conclusions

Portal vein complication after donor right hepatectomy is rare but require proper management. Type 2 and 3 portal vein anomaly donors have a tendency to occur portal vein complication after donor right hepatectomy. Especially donors with type 3 portal vein anomaly should be cautiously harvested graft intraoperatively and followed with image studies.

CITATION INFORMATION: Jung D.-H, Lee S.-G, Hwang S, Kim K.-H, Ahn C.-S, Moon D.-B, Ha T.-Y, Song G.-W, Kim W.-J, Kim S.-H, Kang W.-H, Kwon J.-H, Jwa E.-K, Cho H.-D. Portal Vein Complication After Living Donor Right Hepatectomy. Am J Transplant. 2016;16 (suppl 3).

To cite this abstract in AMA style:

Jung D-H, Lee S-G, Hwang S, Kim K-H, Ahn C-S, Moon D-B, Ha T-Y, Song G-W, Kim W-J, Kim S-H, Kang W-H, Kwon J-H, Jwa E-K, Cho H-D. Portal Vein Complication After Living Donor Right Hepatectomy. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/portal-vein-complication-after-living-donor-right-hepatectomy/. Accessed November 21, 2024.

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