The shortage of deceased donor liver grafts led to the use of living donor liver transplant(LDLT).Patients who un-dergo LDLT have a higher risk of complications than those who undergo deceased donor liver transplantat...The shortage of deceased donor liver grafts led to the use of living donor liver transplant(LDLT).Patients who un-dergo LDLT have a higher risk of complications than those who undergo deceased donor liver transplantation(LT).Interventional radiology has acquired a key role in every LT program by treating the majority of vascular and nonvascular post-transplant complications,improving graft and patient survival and avoiding,in the majority of cases,surgical revision and/or re-transplant.The aim of this paper is to review indications,diagnostic modalities,technical considerations,achievements and potential complications of interventional radiology procedures after LDLT.展开更多
Background:Although left-lobe donation is considered safer,right-sided donor hepatectomy predominatesin adult living donor liver transplantation(LDLT).We hypothesized that bilateral proficiency with donorhepatectomy r...Background:Although left-lobe donation is considered safer,right-sided donor hepatectomy predominatesin adult living donor liver transplantation(LDLT).We hypothesized that bilateral proficiency with donorhepatectomy reduces overall donor complications.Methods:A retrospective review of 834 adult LDLT donors(221 left lobes)from January 2004 toDecember 2014 was performed,dividing cases into two eras based on left-graft experience.Donorcomplications within 6 months were investigated,focusing on graft side and surgical era.Results:The overall complication rate was 17.6%,and was higher in right-lobe donors.In Era 2,duringwhich left-lobe donation rates were three times higher,total complications decreased(14.7%vs.20.9%,P=0.02).A significant reduction in postoperative ascites accounted for the lower overall complication rate.The proportion of major biliary complications(BCs)was halved from 62.5%to 25.0%.Right-lobe donorcomplications also decreased significantly(15.8%vs.22.9%,P=0.032),demonstrating that it was not onlyincreased left-lobe donations leading to lowered complication rates,but also greater experience with donorhepatectomy in general.Conclusions:Accumulating experience with bilateral donor hepatectomy leads to decreased donormorbidity and comparable outcomes for right and left lobes,further enhancing the goal of donor safety whilebalancing recipient needs.展开更多
基金Supported by Grant NSC 96-231-B-182A-009 and NSC 94-231-B-182A-009 from the National Science Council,Taiwan
文摘The shortage of deceased donor liver grafts led to the use of living donor liver transplant(LDLT).Patients who un-dergo LDLT have a higher risk of complications than those who undergo deceased donor liver transplantation(LT).Interventional radiology has acquired a key role in every LT program by treating the majority of vascular and nonvascular post-transplant complications,improving graft and patient survival and avoiding,in the majority of cases,surgical revision and/or re-transplant.The aim of this paper is to review indications,diagnostic modalities,technical considerations,achievements and potential complications of interventional radiology procedures after LDLT.
文摘Background:Although left-lobe donation is considered safer,right-sided donor hepatectomy predominatesin adult living donor liver transplantation(LDLT).We hypothesized that bilateral proficiency with donorhepatectomy reduces overall donor complications.Methods:A retrospective review of 834 adult LDLT donors(221 left lobes)from January 2004 toDecember 2014 was performed,dividing cases into two eras based on left-graft experience.Donorcomplications within 6 months were investigated,focusing on graft side and surgical era.Results:The overall complication rate was 17.6%,and was higher in right-lobe donors.In Era 2,duringwhich left-lobe donation rates were three times higher,total complications decreased(14.7%vs.20.9%,P=0.02).A significant reduction in postoperative ascites accounted for the lower overall complication rate.The proportion of major biliary complications(BCs)was halved from 62.5%to 25.0%.Right-lobe donorcomplications also decreased significantly(15.8%vs.22.9%,P=0.032),demonstrating that it was not onlyincreased left-lobe donations leading to lowered complication rates,but also greater experience with donorhepatectomy in general.Conclusions:Accumulating experience with bilateral donor hepatectomy leads to decreased donormorbidity and comparable outcomes for right and left lobes,further enhancing the goal of donor safety whilebalancing recipient needs.
