Large Riedel's lobe and atrophic left liver in a donor - Accept for transplant or call off?

Anatomical variations Case report Liver transplantation Liver utilization Riedel’s lobe

Journal

World journal of transplantation
ISSN: 2220-3230
Titre abrégé: World J Transplant
Pays: United States
ID NLM: 101608356

Informations de publication

Date de publication:
29 May 2020
Historique:
received: 05 01 2020
revised: 18 03 2020
accepted: 12 05 2020
entrez: 1 9 2020
pubmed: 31 8 2020
medline: 31 8 2020
Statut: ppublish

Résumé

In context of suboptimal liver utilisation, grafts with various risk factors are under consideration today. For example, impaired vascularity with severe arterial calcifications and modified liver shapes are no longer contraindications and their use depends on the centre policy and experience of the surgical team. Riedel liver lobes represent a tongue-like liver shape with inferior projection in the right liver lobe. Such development modifications were initially described when patients developed a lesion and subsequently presented with symptoms. We here present the first case report in the literature, where such livers with anatomical variations were used for transplantation. We describe here two cases of adult human liver transplantation, where we have accepted two donor livers with modified shape. The technical considerations for transplantation of such livers, found with enlarged right lobes, or Riedel shape, and hypo-trophic left lateral segment are highlighted. Both recipients experienced immediate liver function and overall good outcomes with a minimum follow up of 1 year. We also provide detailed pictures and outcome analysis in combination with a literature review. The utilisation of donor livers with modified shape, such as Riedel's Lobe appears safe and will increase the donor pool.

Sections du résumé

BACKGROUND BACKGROUND
In context of suboptimal liver utilisation, grafts with various risk factors are under consideration today. For example, impaired vascularity with severe arterial calcifications and modified liver shapes are no longer contraindications and their use depends on the centre policy and experience of the surgical team. Riedel liver lobes represent a tongue-like liver shape with inferior projection in the right liver lobe. Such development modifications were initially described when patients developed a lesion and subsequently presented with symptoms. We here present the first case report in the literature, where such livers with anatomical variations were used for transplantation.
CASE SUMMARY METHODS
We describe here two cases of adult human liver transplantation, where we have accepted two donor livers with modified shape. The technical considerations for transplantation of such livers, found with enlarged right lobes, or Riedel shape, and hypo-trophic left lateral segment are highlighted. Both recipients experienced immediate liver function and overall good outcomes with a minimum follow up of 1 year. We also provide detailed pictures and outcome analysis in combination with a literature review.
CONCLUSION CONCLUSIONS
The utilisation of donor livers with modified shape, such as Riedel's Lobe appears safe and will increase the donor pool.

Identifiants

pubmed: 32864358
doi: 10.5500/wjt.v10.i5.129
pmc: PMC7428790
doi:

Types de publication

Case Reports

Langues

eng

Pagination

129-137

Informations de copyright

©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.

Déclaration de conflit d'intérêts

Conflict-of-interest statement: All other authors have nothing to disclose.

Références

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Auteurs

Yuhki Sakuraoka (Y)

The Liver Unit, Queen Elizabeth University Hospital Birmingham, Birmingham B15 2TH, United Kingdom.

Rashmi Seth (R)

The Liver Unit, Queen Elizabeth University Hospital Birmingham, Birmingham B15 2TH, United Kingdom.

Amanda Pcs Boteon (AP)

The Liver Unit, Queen Elizabeth University Hospital Birmingham, Birmingham B15 2TH, United Kingdom.

Moira Perrin (M)

The Liver Unit, Queen Elizabeth University Hospital Birmingham, Birmingham B15 2TH, United Kingdom.

J Isaac (J)

The Liver Unit, Queen Elizabeth University Hospital Birmingham, Birmingham B15 2TH, United Kingdom.

Gowri Subash (G)

The Liver Unit, Queen Elizabeth University Hospital Birmingham, Birmingham B15 2TH, United Kingdom.

Paolo Muiesan (P)

The Liver Unit, Queen Elizabeth University Hospital Birmingham, Birmingham B15 2TH, United Kingdom.

Andrea Schlegel (A)

The Liver Unit, Queen Elizabeth University Hospital Birmingham, Birmingham B15 2TH, United Kingdom.

Classifications MeSH