Multiple Hepatic Veins Reconstruction in Right Lobe Grafts in Living Donor Liver Transplantation … Accept or Reject?

Abstract

Abstract Background chronic liver disease and cirrhosis are important causes of morbidity and mortality in the world. Moreover, the burden of chronic liver disease is projected to increase due in part to the increasing prevalence of end-stage liver disease and HCC secondary to NAFLD and HCV. Aim of the Work in this study we will aim to clarify the importance of adequate venous drainage in right lobe grafts in living donor liver transplantation to determine its impact on the graft survival and avoidance of small for size graft syndrome as regard operative time, operative mortality rates (throughout the first month), normalization of liver functions and 6 month, 1 year survival rates of the patients. Patients and Methods our study population includes all the patients who performed right lobe living donor liver transplantation from January 2014 till June 2018 at the liver transplantation unit at Ain Shams Specialized University Hospital and will be classified in our study into 2 groups: First group Patients for whom we performed a single venous anastmosis including 42 cases. Second group Patients for whom we performed multiple venous anastmoses whether an additional single or double or triple anastmoses including 43 cases. Results our study was held as a retrospective cohort study to compare between the patients who received a single venous anastmosis as the first group (n = 42) and the patients who received multiple venous anastmosis as the second group (n = 43). Conclusion so here we can declare, according to our results, that the second group has better survival rates, less mortality rates, better graft survival, better course when daily follow up with full labs is done concerning platelets levels, ALT, direct bilirubin, INR and according to those results we highly recommend multiple hepatic venous anastmosis, if indicated, to acheive the best results in every single LDLT despite the longer cold and warm ischemic time.