For the Right Hemiliver Graft May Need Tissue Expander After Living Donor Liver Transplantation_Crimson Publishers

 For the Right Hemiliver Graft May Need Tissue Expander After Living Donor Liver Transplantation by Batsaikhan B in Surgical Medicine Open Access Journal

Introduction: Hepatic venous outflow is an important for the graft survival in living donor liver transplantation. Hepatic venous outflow obstruction generates liver failure, which may influenced due to graft malposition, which unsized upper part of abdomen between donor and recipient. The number of Liver Transplantation (LT) increases last few years, which is related with populating the high surgical technology in developing country like in Mongolia. The main reason of LT is a hepatitis B virus-related liver cirrhosis in Mongolia. Liver transplantation had started since 2011 under the supporting of Professor Sung Gyu Lee from hepato-biliary surgery and liver transplantation of ASAN Medical Center. Veno-Occlusive Disease (VOD), Budd-Chiari Syndrome (BCS), and Congestive Hepatopathy (CH), all of which results in hepatic venous outflow obstruction. The early Hepatic Venous Outflow Obstruction (HVOO) is a rare, however that could raise a serious complication as a graft failure and eventual lose. We report a case of early HVOO, which may result of size mismatch of abdominal cavity. The size mismatch of abdominal cavity may produce kinking syndrome after transplantation of right lobe, which reveals the HVOO without anastomosis complication. Methods: A 38-year-old male patient with liver cirrhosis due to HBV, HDV, HCC in S8 of the liver (CTP-B, MELD-18). On the first postoperative day the patient developed impairment of the liver function. Doppler ultrasound (US) showed the different speed of RHV preanastomosis and postanastomosis field. This was diagnosed acute liver failure due to veno-oclusive disease, after that started intensive therapy

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