J Korean Soc Transplant.  2006 Dec;20(2):227-233.

Assessment of Technical Feasibility of Living Donor Liver Transplantation after Prior Major Liver Resection for Hepatocellular Carcinoma

• Kim TY
• Hwang S
• Lee SG
• Moon DB
• Ahn CS
• Kim KH
• Park KM
• Lee YJ
• Ha TY
• Song GW
• Jung DH
• Kim BS
• Moon KM

Abstract

Purpose: Liver transplantation has been performed for recurrent hepatocellular carcinoma (HCC) or deterioration of liver function after prior primary liver resection. Prior major liver resection per se is an unfavorable condition for living donor liver transplantation (LDLT). We analyzed the technical feasibility of prior major hepatectomy-graft combinations for salvage LDLT.
Methods
Of the 17 patients who underwent salvage LDLT, 5 underwent prior major liver resection.
Results
Two patients with prior left lobectomy received right lobe graft, whereas, of the 3 patients with prior right lobectomy, 2 received right lobe graft and 1 received left lobe graft. During recipient hepatectomy, it was necessary to perform meticulous sharp dissection of the previous liver cut surface to attain full mobilization. Different methods of hepatic vein reconstruction were applied after the recipient inferior vena cava was fully dissected. Reconstruction of the portal vein, hepatic artery and bile duct were performed on case by case basis depending on the remnant hilar structures. Conclusion: In conclusion, every combination of recipient prior right or left lobectomy and living donor right or left liver graft seems to be feasible for salvage LDLT.

Keyword

Salvage liver transplantation; Living donor liver transplantation; Hepatocellular carcinoma

MeSH Terms

Bile Ducts
Carcinoma, Hepatocellular*
Hepatectomy
Hepatic Artery
Hepatic Veins
Humans
Liver Transplantation*
Liver*
Living Donors*
Portal Vein
Transplants
Vena Cava, Inferior