Right anterior section graft for living-donor liver transplantation: A case report

In living-donor liver transplantation (LDLT), the right lobe graft is commonly utilized to prevent small-for-size syndrome, despite the considerable donor morbidity. Conversely, the feasibility of the left lobe graft and the right posterior section graft in smaller-sized recipients is now commonly e...

Full description

Saved in:
Bibliographic Details
Published in:Medicine (Baltimore) 2019-05, Vol.98 (19), p.e15212-e15212
Main Authors: Navarro, Jonathan Geograpo, Choi, Gi Hong, Kim, Myoung Soo, Jung, Yoon Bin, Lee, Jae Geun
Format: Article
Language:English
Subjects:
Adult
Alcoholism - complications
Clinical Case Report
Family
Humans
Liver - diagnostic imaging
Liver - surgery
Liver Cirrhosis, Alcoholic - diagnostic imaging
Liver Cirrhosis, Alcoholic - surgery
Liver Transplantation - methods
Living Donors
Male
Middle Aged
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:In living-donor liver transplantation (LDLT), the right lobe graft is commonly utilized to prevent small-for-size syndrome, despite the considerable donor morbidity. Conversely, the feasibility of the left lobe graft and the right posterior section graft in smaller-sized recipients is now commonly employed with comparable outcomes to right lobe grafts. The efficacy of the right anterior section graft has rarely been reported. A 56-year-old man, a heavy alcoholic beverage drinker for 20 years, presented in the emergency department with massive ascites and lethargy. He was previously admitted twice due to bleeding esophageal varices. He was diagnosed with hepatic encephalopathy coma due to alcoholic liver cirrhosis. The Child-Turcotte-Pugh score was 11 (class C), and the Model for End-stage Liver Disease score was 21.62. A LDTL was offered to the patient as the best treatment option available. The patient's 26-year-old son was found to be the only donor-compatible candidate for the LDTL.Preoperatively, the right lobe of the donor occupied 76.2% of the total liver volume exposing the donor to a small residual liver volume. The right posterior section and left lobe volumes were insufficient, providing a graft-to-recipient weight ratio of 0.42% and 0.38%, respectively. However, the right anterior section could fulfill an acceptable GRWR of 0.83%. Thus, a living donor right anterior sectionectomy was performed. Clinical signs and symptoms and liver function improved following anterior section graft transplantation without complications. The procurement of anterior section graft is technically feasible in selected patients, especially in high-volume liver centers.
ISSN:0025-7974
1536-5964
DOI:10.1097/MD.0000000000015212