How do transplant surgeons accomplish optimal portal venous flow during living-donor liver transplantation? noninvasive measurement of indocyanine green elimination rate

Tomohide Hori, Yasuhiro Ogura, Shintaro Yagi, Taku Iida, Kentaro Taniguchi, Walid M.El Moghazy, Mohammed Saied Hedaya, Hajime Segawa, Kohei Ogawa, Takayuki Kogure, Shinji Uemoto

研究成果: Article査読

7 被引用数 (Scopus)

抄録

Background. Balancing donor safety and graft volume is difficult. We previously reported that intentional modulation of portal venous pressure (PVP) during living-donor liver transplantation (LDLT) is crucial to overcoming problems with small-for-size grafts; however, detailed studies of portal venous flow (PVF) and a reliable parameter are still required. Patients and Methods. The elimination rate (k) of indocyanine green (ICG) was measured in 49 adult LDLT recipients. PVP was controlled during LDLT, with a target of <20 mm Hg. ICG reflects hepatocyte volume and effective PVF. The kICG value is divided by the graft weight to calculate PVF. Recipients were divided into 2 groups: those with severe and/or fatal complications within 1 month after LDLT and those without. Results. Survival rates and postoperative profiles were significantly different between the 2 groups. Univariate analysis showed significant differences in ABO blood group, final PVP, final kICG, and the final kICG/graft weight value; however, multivariate analysis showed that only the kICG/graft weight value was significant. The cutoff level for the final kICG/graft weight value for predicting successful LDLT was 3.1175 × 10-4/g. Conclusion. Accurate evaluation and monitoring of optimal PVF during LDLT should overcome the use of small-for-size grafts and improve donor safety and recipient outcomes.

本文言語English
ページ(範囲)43-51
ページ数9
ジャーナルSurgical Innovation
21
1
DOI
出版ステータスPublished - 2014 2

ASJC Scopus subject areas

  • 外科

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