J Korean Soc Transplant.  2006 Dec;20(2):149-159.

Technical Evolution in Living Donor Liver Transplantation

• Yi NJ
• Suh KS

Abstract

During the last 15 years, much progress has been made in the technical aspect of living donor liver transplantation (LDLT). In fact, LDLT has contributed to understanding of the detailed anatomy of the liver and performing more precise hepatectomy. Recently, more complex cases which were relative contraindications for liver transplantation such as Budd-Chiari syndrome and portal vein thrombosis have been challenged in LDLT area. This review focuses on donor hepatectomy and hanging maneuver in the donor, and hilar dissection and venous reconstruction in the recipient. In addition, recent technical advances in complex cases were also introduced. Biliary complication has been the most common, intractable complication to disturb the quality of life of the long-term survivors. Reduction of its complication rate is a pending question of the transplant surgeon. In LDLT, donor safety is paramount. Technical innovations should be balanced with any unexpected harm to the donors.

Keyword

Living donor liver transplantation; Donor hepatectomy; Hanging maneuver; Outflow reconstruction; Portal vein thrombosis

MeSH Terms

Budd-Chiari Syndrome
Hepatectomy
Humans
Liver Transplantation*
Liver*
Living Donors*
Quality of Life
Survivors
Tissue Donors
Venous Thrombosis