Application Effectiveness of Segment IV Portal Vein Reconstruction for Early Postoperative Liver Function Recovery in Split Liver Transplantation

The objective of this study was to investigate the significance of portal vein reconstruction in segment IV of the liver on early postoperative liver function recovery in split liver transplantation. The clinical data of patients of right trilobe split liver transplantation in our center were analyzed and divided into two groups, including a group without portal vein reconstruction and a group with portal vein reconstruction. Clinical data of alanine aminotransferase (ALT), aspartate transaminase (AST), albumin (ALB), creatinine (Cr), total bilirubin (TB), alkaline phosphatase (ALP), gamma-glutamyl Transferase (GGT), lactic acid (Lac), and international normalized ratio (INR) levels were analyzed. The technique of segment IV portal vein reconstruction is beneficial to the early postoperative recovery of liver function. Statistically, there was no significant effect of portal vein reconstruction in the IV segment of the liver on the recovery of liver function within 1 week after split liver transplantation. There was no significant difference in survival rate between the control group and reconstruction group over the 6 months follow-up period after surgery. Graphical Abstract

[1]  G. Song,et al.  Prognosis of Split Liver Transplantation Compared with Whole Liver Transplantation in Adult Patients: Single-center Results under the Korean MELD Score-based Allocation Policy , 2020, Journal of Korean medical science.

[2]  J. Lai,et al.  Split‐Liver Allocation: An Underused Opportunity to Expand Access to Liver Transplantation , 2019, Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.

[3]  Sanghoon Lee,et al.  Survival Outcomes in Split Compared With Whole Liver Transplantation , 2018, Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.

[4]  N. Goyal,et al.  In Situ Splitting of the Cadaver Liver for Two Adult Recipients by LDLT Technique. , 2017, Journal of clinical and experimental hepatology.

[5]  T. Berney,et al.  Early complications after liver transplantation in children and adults: Are split grafts equal to each other and equal to whole livers? , 2017, Pediatric transplantation.

[6]  A. Cosimi,et al.  Outcomes of Full-Right-Full-Left Split Liver Transplantation in Adults in the USA: A Propensity-Score Matched Analysis , 2016, International Journal of Organ Transplantation Medicine.

[7]  J. Fung,et al.  Split Liver Transplantation Using Hemiliver Graft in the MELD Era: A Single Center Experience in the United States , 2014, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[8]  V. Mazzaferro,et al.  A Prospective Policy Development to Increase Split-Liver Transplantation for 2 Adult Recipients: Results of a 12-Year Multicenter Collaborative Study , 2014, Annals of surgery.

[9]  Johnny C. Hong,et al.  Where are we today in split liver transplantation? , 2011, Current opinion in organ transplantation.

[10]  S. Emre,et al.  Split liver transplantation: an overview. , 2011, Transplantation proceedings.

[11]  R. Schaffer,et al.  Split‐liver transplantation in the high‐MELD adult patient: are we being too cautious? , 2009, Transplant international : official journal of the European Society for Organ Transplantation.

[12]  M. Spada,et al.  In situ split liver transplantation for adult and pediatric recipients: an answer to organ shortage. , 2006, Transplantation proceedings.

[13]  V. Mazzaferro,et al.  Split and whole liver transplantation outcomes: A comparative cohort study , 2006, Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.

[14]  R. Harrington Part II , 2004, Bitter Freedom.

[15]  J. Emond,et al.  Split‐Liver Transplantation: A Review , 2003, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[16]  R. Busuttil,et al.  One Hundred In Situ Split-Liver Transplantations: A Single-Center Experience , 2003, Annals of surgery.

[17]  J. Schulte am Esch,et al.  Split-Liver Transplantation , 2002 .

[18]  R. Busuttil,et al.  Technical and logistical considerations of in situ split‐liver transplantation for two adults: Part II. Creation of left segment I‐IV and right segment V‐VIII grafts , 2002, Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.

[19]  R. Busuttil,et al.  Technical and logistical considerations of in situ split‐liver transplantation for two adults: Part I. Creation of left segment II, III, IV and right segment I, V‐VIII grafts , 2001, Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.

[20]  E. Achilles,et al.  Is There Still a Need for Living-related Liver Transplantation in Children? , 2001, Annals of surgery.

[21]  H. Bismuth,et al.  Split-Liver Transplantation for Two Adult Recipients: Feasibility and Long-Term Outcomes , 2001, Annals of surgery.

[22]  R. Busuttil,et al.  Surgical advances in liver transplantation. Living related and split donors. , 2000, Clinics in liver disease.

[23]  Louise Poissant Part I , 1996, Leonardo.

[24]  H. Bismuth,et al.  Split-liver Transplantation: The Paul Brousse Policy , 1996 .

[25]  M. Morino,et al.  Emergency orthotopic liver transplantation in two patients using one donor liver , 1989, The British journal of surgery.

[26]  H. Bismuth,et al.  Reduced-sized orthotopic liver graft in hepatic transplantation in children. , 1984, Surgery.

[27]  T. Starzl,et al.  Orthotopic homotransplantation of the human liver. , 1968 .

[28]  P. Mahadevan,et al.  An overview , 2007, Journal of Biosciences.

[29]  D. Samuel,et al.  Paul Brousse Liver Transplantation: the first 1,500 cases. , 2000, Clinical transplants.

[30]  Robert C. Wolpert,et al.  A Review of the , 1985 .