---- Hepatobiliary & Pancreatic Diseases International (HBPD INT), the First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou 310003, China.
See Ching Chan, Chung Mau Lo and Sheung Tat Fan
Hong Kong, China
Author Affiliations: Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong, China (Chan SC, Lo CM and Fan ST)
Corresponding Author: Sheung Tat Fan, Professor, Department of Surgery, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, China (Tel: 852-2855 4703; Fax: 852-2986 5262; Email: stfan@hku.hk)
BACKGROUND: Living donor liver transplantation is a complex surgical operation. Treatment policies and operative techniques evolved in the last two decades.
DATA SOURCES: Our center s experience in living donor liver transplantation was reviewed in conjunction with relevant publications in the literature.
RESULTS: The surgical techniques and perioperative surgical therapeutics could be modified towards simplicity. Examples include regular inclusion of the middle hepatic vein without compromising the venous outflow of the donor s remnant left liver. This provides excellent venous outflow, which is crucial for a small-for-size graft. Immunosuppression and hepatitis B suppression are steroid free and hepatitis B immunoglobulin free respectively.
CONCLUSION: The most practical way to achieve high graft and recipient survival rates with an acceptably low donor risk is through design of a protocol that simplifies the surgery and postoperative management.
(Hepatobiliary Pancreat Dis Int 2010; 9: 9-14)
KEY WORDS: simplifying; right liver; living donor; liver transplantation
