Autologous Versus Synthetic Grafts in Anterior Sector Drainage in Right Lobe Living Donor Liver Transplantation, MAHMOUD A. ALI, MOHAMMAD M. ELSHOBARY, NABIEH A. ELGHAWALBY, AYMAN ELNAKEEB and LUCIANO DE CARLIS
Abstract
Background: In modified Right Lobe (RL) grafts, various graft materials have been proposed to reconstruct the venous tributaries of the Middle Hepatic Vein (MHV). In this study, we evaluated natural and synthetic grafts used for drainage of MHV tributaries in RL LDLT.
Patients and Methods: During the study period, patients who underwent reconstruction of MHV tributaries using synthetic and natural grafts were included in the study. Cases were followed-up by Doppler ultrasonography for the graft patency for 6 months.
Results: Seventy-two patients were included in the study. The mean age is 50.1 years. Sixty-one of the patients were males, (84.7%). In the natural graft group, the 1-, 3- and 6- month patency rates were all 76% while in the synthetic graft group, the 1-, 3- and 6 month patency rates were 66%, 59% and 59% respectively (p=0.225). Patients with thrombosed grafts within the first week showed a significantly higher ALT on day 1 and day 3. Early graft obstruction was not associated with increased risk of operative mortality.
Conclusion: Natural and synthetic grafts are good options for anterior section drainage in RL LDLT with good patency.