Total hepatectomy during living donor liver transplantation at 108 Military Central Hospital

Abstract

Objective: To evaluate the results and summarizing the experiences of total hepatectomy in living donor liver transplantation. Subject and method: A cross-sectional, descriptive study, over 165 cases of living donor liver transplantation at 108 Military Central Hospital from January 2019 to April 2023. Result: The average age of patients was 51.57 ± 13.19 years old, HBV infection rate was 70.9%. Indications for liver transplantation include acute liver failure (2.4%), acute on chronic liver failure (34%), decompensated cirrhosis (24.8%), hepatocellular carcinoma (37%), intrahepatic cholangiocarcinoma (1.2%), liver metastases from colon cancer (0.6%). High hilum dissection of the hepatic artery in continuity with the bile duct rate was 95.2%, individual dissection in 3% and total occlusion in 1.8% of cases. The left and middle hepatic veins trunk was divided before segment 1 dissection in 95.8% of patients. Average time of total hepatectomy was 148.12 ± 38.9 minutes, average blood loss during total hepatectomy was 867 ± 442ml. Conclusion: High hilum dissection of the hepatic artery in continuity with the bile duct combined with left and middle hepatic veins trunk divided before dissecting of the segment 1 is safe and feasible for total hepatectomy during living donor liver transplantation.