A clinical report about distributions of hepatic veins in ex vivo adult to adult split liver transplantation

Objective To investigate clinical respective effects on 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 from Jan 2007 to Oct 2011.The analysis was focused on the distribution and reconstruction of hepatic veins,and monitoring the vascular complications and patient's prognosis.Results There were four types about distribution of hepatic vein in 6 right hemi-liver grafts: one graft got RHV(right hepatic vein)+MHV(middle hepatic vein)+Vena cava;two cases 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 segments reconstructed;LHV+MHV;LHV+MHV+Vena cava;LHV+ hemi-MHV.One recipient with LHV+vein of 4 segments reconstructed left liver graft occurred small for size syndrome for occlusion of reconstructed 4 segmental veins and eventually died.Other recipients had no complications related with hepatic vein.Conclusions Multiple methods exist when we face to distribution and reconstruction of hepatic vein in adult to adult split liver transplantation.Before making a decision on how to split hepatic vein in clinical procedure,it is necessary to prove the functional graft volume enough first,then considering patient's conditions and feasibility of surgical procedures.