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KMID : 0361120060200020227
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Korean Journal of Transplantation
2006 Volume.20 No. 2 p.227 ~ p.233
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Assessment of Technical Feasibility of Living Donor Liver Transplantation after Prior Major Liver Resection for Hepatocellular Carcinoma
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김태영
황신/이승규/문덕복/안철수/김기훈/박광민/이영주/하태용/송기원/정동환/김범
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Abstract
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Purpose: Liver transplantation has been performed for recurrent hepatocellular carcinoma (HCC) or deterioration
of liver function after prior primary liver resection. Prior major liver resection per se is an unfavorable condition
for living donor liver transplantation (LDLT). We analyzed the technical feasibility of prior major
hepatectomy-graft combinations for salvage LDLT. Methods: Of the 17 patients who underwent salvage LDLT,
5 underwent prior major liver resection. Results: Two patients with prior left lobectomy received right lobe graft,
whereas, of the 3 patients with prior right lobectomy, 2 received right lobe graft and 1 received left lobe graft.
During recipient hepatectomy, it was necessary to perform meticulous sharp dissection of the previous liver cut
surface to attain full mobilization. Different methods of hepatic vein reconstruction were applied after the
recipient inferior vena cava was fully dissected. Reconstruction of the portal vein, hepatic artery and bile duct
were performed on case by case basis depending on the remnant hilar structures. Conclusion: In conclusion,
every combination of recipient prior right or left lobectomy and living donor right or left liver graft seems to be
feasible for salvage LDLT. (J Korean Soc Transplant 2006;20:227-233)
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KEYWORD
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