Key Frames

  • Living donor clinic case presentation CT scan evaluation Description of liver volume Radiological feature of vascular liver anatomy and plan of liver trasection
  • Liver mobilization Piggye back maneuver Isolation of right hepatic vein
  • Preparation of pringle maneuver Intraoperative cholangiography Hylar dissection Ultrasound liver evaluation of parenchymal slice transection along cantle line Hanging maneuver
  • Liver transection Back table surgery with graft preparation
  • Presentation of the recipient Total hepatectomy
  • Liver transplantation Hepatic vein anastomosys Portal vein anastomosys Arterial vein anastomosys Biliary duct anastomosys with silastic stent reconstruction
  • Postoperative CT scan Liver volume evalutation

Prof. Salvatore Gruttadauria: Living donor right hepatectomy

Intervention Description

A 61-year-old female affected by primary biliary cirrhosis was listed in our Center for deceased donor liver transplantation  (DDLT). Her biochemical MELD score was 12 at the time of listing, but due to an intractable pruritis, she gained an exception point, increasing the MELD score to 15.

A few months after her listing, her 31-year-old son decided to be evaluated as a potential right hepatic lobe live donor. The live donor surgical procedure consisted of an open right hepatectomy (Couinaud segment 5–8) performed according to our technique described elsewhere The recipient surgery was a liver transplant performed with the piggyback technique and total veno-venous bypass. Modulation of the venous outflow was achieved with a right hepatic vein venoplasty, achieved by enlarging the ostium of the right hepatic vein into the inferior vena cava.

Primo Operatore

Prof. Salvatore Gruttadauria

M.D. - Ph. D. - FACS Direttore Dipartimento per la Cura e lo Studio delle Patologie Addominali e dei Trapianti Addominali IRCCS-ISMETT – University of Pittsburgh Medical Center in Italy (UPMCI)
Contatti

Secondo Operatore

Dott. Alessandro Tropea

M.D. – Ph. D -FACS
Attending physician in abdominal and transplantation surgery

IRCCS-ISMETT – University of Pittsburgh Medical Center in Italy (UPMCI)

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