The Research Of Middle Hepatic Vein Choice Standards In The Right Lobe Donator Living Donor Liver Transplantation

【Objective】The research about the influence to donors in right lobe donator LDLT with or without middle hepatic vein,find the theoretical basis for protect the safety of the donor and provide reference for our future clinical work.【Method】30 donors were divided into two groups according to the position of MHV when they donation their right lobe.Group A(n=15)with their MHV and group B(n=15)without.There are no significant statistical difference in the character of these two groups.After the donors were performed right lobe hepatectomy for donation.We collect and compare the data include:whole liver volume,right lobe volum,GRWR,operation time,blood loss volume,ascites volume of postoperative, complication and survival rate.We still measured actual volume,the peak value of lactic acid,liver function of 1,3,5,7,9,11 days postoperation.And we overview the blood flow of HA,PV.【Results】(1)CT measured total hepatic volume in group A is 1274.79±144.60mm3 and 1406.56±186.76 mm3 in group B;the two groups have statistics differences,we still found statistical difference of two groups in CT measured right lobe volume and significant statistics differences in GRWR,CT measured right liver volume/receptor estimated liver volume.The actual volume of graft we test during operation has not statistical difference.(2)There are no significant difference in total operation time,liver resection time and blood loss After graft be removed the lactate peak during operation were 3.72±0.38mmol/L and 3.16±0.71mmol/L,there is a significant difference between the two groups.(3)According to ultrasound during-operation the group A faster than group B of the left hepatic artery blood flow speed,Left branch of portal vein flow rate after graft removed.(4)We found some significant statistics differences of ascites,drainage volume,total bilirubin,ALT,AST and ALB level in the ealy stage after operation.We only found statistics differences of FIB level at first day after operation and after that there is no statistics differences between two groups.However,almost all indicators between the two groups difference disappeared in about two weeks after operation.There are no biliary fistula, bleeding,thrombosis,and other related complications in all donors.After 3 month～1 year follow up does not appear postoperative complications.【Conclusion】(1)This experiment confirmed,according to my current center in the vein of liver allocation principle,whether to retain in the vein of the liver donor had no effect on security.(2)The donor hepatic vein for reservations,slower recovery after operation,ascites reduced slower,with reservations abdominal partial long time, FIB lower,we should pay attention to treatment in time.