How Far Does Residual Liver Volume Affect Portal Pressure Gradient During Donor Hepatectomy in Living Donor Liver Transplantation

Abstract

AbstractBackground: Living donor liver transplantation (LDLT) is now a solution for end stage liver disease, In living donors, up to 70% of the whole liver volume can be donated. Relative portal hypertension (increase of the portal pressure after donor hepatectomy as compared to the preoperative state was ob-served. Several factors affect portal pressure gradient in LDLT, we evaluate the effect of residual liver volume (RLV) on the portal pressure gradient.Aim of Study: In this study we aimed to studying the correlation between portal pressure gradient and residual liver volume after donor hepatectomy in living donor liver trans-plantation.Patients and Methods: This prospective study included 30 adult living donors who underwent right hepatectomy in Liver Transplantation Unit, Faculty of Medicine, Cairo Uni-versity during the period between June 2015 to October 2016. Inclusion criteria an age group from 21 to 50 years with a residual liver volume >_ 35%. Computed Tomography volum-etry was done to all donors to calculate the graft weight recipient ratio and the residual liver volume of the donor. PVP was measured intra-operatively using wide gauge cannula preclamping and postclamping of portal vein.Results: The mean portal pressure before and after clamp-ing of right portal vein was 9.9mmHg and 15.23mmHg re-spectively (p<0.001). The portal venous gradient is negatively correlated with RLV (p-value 0.029).Conclusion: The study has demonstrated a significant rise in PVP post clamping of right portal vein. Also, the lower the percentage of residual liver volume the higher the changes in portal venous pressure.