关键词: 肝移植, 劈离, 肝静脉, 成人间

Abstract: 0bjective:To investigate clinical respective effects about different distribution of hepatic veins in adult to adult split liver transplantation(SLT) ex vivo．Methods: A retrospective analysis was conducted on 12 adult to adult split liver transplantations performed at Tianjin First Centra1 Hospital between Jan 2007 and Oct 2011．The analysis was focused on the distribution and reconstruction of hepatic veins. Monitor the vascular complications and patient’s prognosis. Results: There were four types about distribution of hepatic vein in 6 right hemi-liver. Grafts. Only 1 graft got RHV( right hepatic vein)+MHV(middle hepatic vein)+Vena cava; 2 case was with RHV+5,8 vein reconstruction +Vena cava; another 2 grafts obtained RHV+5,8 segmental vein reconstruction; the last one was consist of RHV+ hemi-MHV +Vena cava. For split liver 6 corresponding left grafts had 4 variations as: LHV(left hepatic vein)+vein of 4 segment reconstructed; LHV+MHV; LHV+MHV+ Vena cava; LHV+hemi-MHV. One recipient with LHV+vein of 4 segment reconstructed left liver graft occurred small for size syndrome for occlusion of reconstructed 4 segmental vein and eventually died. Other recipients had no complications related with hepatic vein. Conclusions: Multiple methods existes when we face with distribution and reconstruction of hepatic vein in adult to adult split liver transplantation. Before we make a decision on how to split hepatic vein in clinical procedure, we should prove the functional graft volume enough first, then reference patient’s conditions and feasibility of surgical procedures.

Key words: Liver transplant, Split, Hepatic vein, Adult to adult