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Major hepatic resection as a liver graft procedure
DETRY, Olivier; HONORE, Pierre; DETROZ, Bernard et al.
2000In Transplantation, 69, p. 178
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Abstract :
[en] Background: Retransplantation for failing graft is common after liver transplantation. However, in the present organ shortage era, every attempt to save the graft should be performed before registration of patients on the waiting list for retransplantation. The aim of this paper is to report our experience with right hepatectomy as a graft saving procedure in liver recipients. Material and Methods: In a consecutive series of 170 orthotopic liver transplantations (OLT) in adults, 4 male patients (mean age 45, 23 to 55) underwent right hepatectomy (Segments V, VI, VII, VIII) in the post transplant period. Causes of liver failure leading to OLT were HCV in 3 cases and acute liver failure secondary to Wilson’s disease in one. Three patients developed intrahepatic biliary strictures, related to late hepatic artery thrombosis in one case. As these biliary strictures were mainly localized in the right part of the liver, classical right hepatectomy was performed (delay between OLT and right hepatectomy: 14, 75, 78 months). The fourth patient developed post transplant parenchymal infarcts in the right liver, secondary to ischemic damage to the graft. This patient underwent right hepatectomy 48 hours after OLT. In all cases, classical right hepatectomy was performed without Pringle’s maneuver and without mobilization of the left liver in order to preserve its vascularization. Results: All patients are alive without retransplantation (mean follow-up 28 months, 13 to 48). One patient developed postoperative biliary fistula treated conservatively. Mean postoperative hospital stay was 20 days. Conclusions: Right hepatectomy may be proposed as a graft saving option in selected liver recipients with excellent outcome on both patient and graft survival.
Disciplines :
Surgery
Author, co-author :
DETRY, Olivier  ;  Centre Hospitalier Universitaire de Liège - CHU > Département de chirurgie > Chirurgie abdo, sénologique, endocrine et de transplantation
HONORE, Pierre ;  Centre Hospitalier Universitaire de Liège - CHU > Département de chirurgie > Chirurgie abdo, sénologique, endocrine et de transplantation
DETROZ, Bernard ;  Centre Hospitalier Universitaire de Liège - CHU > Département de chirurgie > Chirurgie abdo, sénologique, endocrine et de transplantation
HAMOIR, Etienne ;  Centre Hospitalier Universitaire de Liège - CHU > Département de chirurgie > Chirurgie abdo, sénologique, endocrine et de transplantation
Defechereux, T
MEURISSE, Michel ;  Centre Hospitalier Universitaire de Liège - CHU > Département de chirurgie > Chirurgie abdo, sénologique, endocrine et de transplantation
Jacquet, N
Language :
English
Title :
Major hepatic resection as a liver graft procedure
Publication date :
2000
Event name :
18th International Congress
Event organizer :
Transplantation Society
Event place :
Rome, Italy
Event date :
August 2000
Audience :
International
Journal title :
Transplantation
ISSN :
0041-1337
eISSN :
1534-6080
Publisher :
Lippincott Williams & Wilkins, United States - Maryland
Volume :
69
Pages :
S178
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 23 April 2019

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