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Purpose <p>There are few studies on the reconstruction of the middle hepatic vein (MHV) tributaries in split liver transplantation (SLT) using right lobe grafts. This study aimed to compare the outcomes of patients undergoing combined reconstruction of MHV tributaries and the right hepatic vein (RHV) versus those undergoing separate reconstruction.</p> Methods <p>Clinical data of 114 patients who underwent SLT from March 2021 to December 2023 were retrospectively collected. We analyzed and compared the postoperative outcomes and reconstructed MHV patency between different modalities of MHV tributaries reconstruction in the right lobe SLT.</p> Results <p>Forty-five right lobe grafts were reconstructed with the MHV tributaries and were divided into two groups according to the type of reconstruction. Group 1 (<i>n</i> = 19) received separate reconstruction, while Group 2 (<i>n</i> = 26) received combined reconstruction. The duration of warm ischemia in Group 2 was significantly less than that in Group 1 (47.9 ± 7.8 vs. 59.7 ± 15.6&#xa0;min, <i>P</i> = 0.002), and the ICU hospitalization time was significantly less in Group 2 than in Group 1 (2 vs. 3 days, <i>P</i> = 0.022). The complete patency rate of the reconstructed MHV at 30 days postoperatively was higher in Group 2 than in Group 1 (96.2% vs. 68.4%, <i>P</i> = 0.031). The rates of postoperative complications were comparable between the two groups.</p> Conclusion <p>Combined reconstruction of the MHV tributaries and RHV in SLT improves the rate of complete patency of the reconstructed MHV, reduces warm ischemia time, and shortens the length of ICU stay.</p>

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Comparison of combined versus separate reconstruction of middle hepatic vein tributaries in the right lobe split liver transplantation

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月9日

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  • Zhengwei Lin,
  • Fei Feng,
  • Qi Yu,
  • Yingpeng Ye,
  • Yong Yang,
  • Hongda Zhu,
  • Shengdong Wu,
  • Jing Huang,
  • Caide Lu,
  • Jiongze Fang

摘要

Purpose

There are few studies on the reconstruction of the middle hepatic vein (MHV) tributaries in split liver transplantation (SLT) using right lobe grafts. This study aimed to compare the outcomes of patients undergoing combined reconstruction of MHV tributaries and the right hepatic vein (RHV) versus those undergoing separate reconstruction.

Methods

Clinical data of 114 patients who underwent SLT from March 2021 to December 2023 were retrospectively collected. We analyzed and compared the postoperative outcomes and reconstructed MHV patency between different modalities of MHV tributaries reconstruction in the right lobe SLT.

Results

Forty-five right lobe grafts were reconstructed with the MHV tributaries and were divided into two groups according to the type of reconstruction. Group 1 (n = 19) received separate reconstruction, while Group 2 (n = 26) received combined reconstruction. The duration of warm ischemia in Group 2 was significantly less than that in Group 1 (47.9 ± 7.8 vs. 59.7 ± 15.6 min, P = 0.002), and the ICU hospitalization time was significantly less in Group 2 than in Group 1 (2 vs. 3 days, P = 0.022). The complete patency rate of the reconstructed MHV at 30 days postoperatively was higher in Group 2 than in Group 1 (96.2% vs. 68.4%, P = 0.031). The rates of postoperative complications were comparable between the two groups.

Conclusion

Combined reconstruction of the MHV tributaries and RHV in SLT improves the rate of complete patency of the reconstructed MHV, reduces warm ischemia time, and shortens the length of ICU stay.