{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T13:23:53Z","timestamp":1769520233495,"version":"3.49.0"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2004,2,1]],"date-time":"2004-02-01T00:00:00Z","timestamp":1075593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2004,1,30]],"date-time":"2004-01-30T00:00:00Z","timestamp":1075420800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2004,2]]},"abstract":"<jats:sec>\n            <jats:title\/>\n            <jats:p>Clamping of the portal triad accomplishes complete inflow occlusion. This maneuver is commonly used during liver surgery to minimize blood loss but is not widely used in living donors undergoing resection for liver transplantation. We compared outcomes in living donors who underwent resection with and without inflow occlusion. We reviewed data on 2 nonsimultaneous living liver donor cohorts. The first 20 donors (group 1) underwent resection without inflow occlusion. In the next 15 donors (group 2), inflow occlusion was used during parenchymal transection, using cycles of 10-15 minutes occlusion and 6 minutes reperfusion. In donors, we recorded type of resection; ischemia times; blood loss; transfusions; peak ALT, AST, bilirubin, and INR in the first 5 days; hospital length of stay (LOS), and major complications. In recipients, we recorded peak ALT. In group 1, 19 of 20 donors underwent right hepatectomy. In group 2, 8 donors underwent right hepatectomy, and 7 donors had left lobectomies. Total ischemic time ranged from 16-49 minutes (mean, 31 \u00b1 9 minutes). In group 1, two donors received a total of 5 U of allogeneic blood. In group 2, no donor required transfusion. Mean peak ALT was significantly higher in group 1 (521 \u00b1 336 U\/L) than group 2 (322 \u00b1 162 U\/L; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.03). Mean INR was significantly higher in group 1 (1.8 \u00b1 0.2) vs. group 2 (1.5 \u00b1 0.2; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.001). There were 4 major complications in group 1 (incisional hernia, transient liver failure, biliary stricture, and biliary leak) and no major intraoperative or postoperative complications in group 2. Mean LOS was significantly longer in group 1 (7.9 \u00b1 2.9 days) than group 2 (6.2 \u00b1 1.1 days; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.04). Mean peak ALT in recipients trended lower in group 2. In conclusion, inflow occlusion was associated with reduced blood loss and less ischemic injury to hepatic remnants in the donors and the grafts in the recipients. These benefits were associated with a diminished incidence of major complications and shorter LOS. Inflow occlusion should be an essential part of living donor hepatectomy. (Liver Transpl 2004;10:244-247.)<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/lt.20071","type":"journal-article","created":{"date-parts":[[2004,1,31]],"date-time":"2004-01-31T00:00:52Z","timestamp":1075507252000},"page":"244-247","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":40,"title":["Intermittent inflow occlusion in living liver donors: Impact on safety and remnant function"],"prefix":"10.1097","volume":"10","author":[{"given":"Charles M.","family":"Miller","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Masetti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Cautero","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabrizio","family":"DiBenedetto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Augusto","family":"Lauro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Romano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristiano","family":"Quintini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Siniscalchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruno","family":"Begliomini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio D.","family":"Pinna","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-11-20250326","doi-asserted-by":"crossref","first-page":"155161","DOI":"10.1097\/00000658-199608000-00007","article-title":"Portal triad clamping or hepatic vascular exclusion for major liver resection. A controlled study.","volume":"224","author":"Belghiti","year":"1996","journal-title":"Ann Surg"},{"key":"R2-11-20250326","first-page":"2511259","article-title":"Liver ischemia for hepatic resection: where is the limit?","volume":"111","author":"Huguet","year":"1992","journal-title":"Surgery"},{"key":"R3-11-20250326","first-page":"824883","article-title":"Total vascular exclusion for major hepatectomy in patients with abnormal liver parenchyma.","volume":"130","author":"Emre","year":"1995","journal-title":"Arch Surg"},{"key":"R4-11-20250326","doi-asserted-by":"crossref","first-page":"704713","DOI":"10.1097\/00000658-199712000-00007","article-title":"Prospective evaluation of the Pringle maneuver in hepatectomy for liver tumors by a randomized study.","volume":"226","author":"Man","year":"1997","journal-title":"Ann Surg"},{"key":"R5-11-20250326","first-page":"155158","article-title":"Safety of hemihepatic vascular occlusion during resection of the liver.","volume":"164","author":"Makuuchi","year":"1987","journal-title":"Surgery, Gynecology and Obstetrics"},{"key":"R6-11-20250326","first-page":"454458","article-title":"Hepatic resection with ischemia of the liver exceeding one hour.","volume":"178","author":"Huguet","year":"1994","journal-title":"J Am Coll Surg"},{"key":"R7-11-20250326","doi-asserted-by":"crossref","first-page":"224226","DOI":"10.1002\/bjs.1800790311","article-title":"Partial hepatic resection under intermittent hepatic inflow occlusion in patients with chronic liver disease.","volume":"79","author":"Ezaki","year":"1992","journal-title":"Br J Surg"},{"key":"R8-11-20250326","doi-asserted-by":"crossref","first-page":"155162","DOI":"10.1097\/00000658-200008000-00001","article-title":"Protective effects of ischemic preconditioning for liver resection performed under inflow occlusion in humans.","volume":"232","author":"Clavien","year":"2000","journal-title":"Ann Surg"},{"key":"R9-11-20250326","doi-asserted-by":"crossref","first-page":"11051110","DOI":"10.1002\/bjs.1800820833","article-title":"Liver resection without blood transfusion.","volume":"82","author":"Gozzetti","year":"1995","journal-title":"Br J Surg"},{"key":"R10-11-20250326","doi-asserted-by":"crossref","first-page":"20492050","DOI":"10.1016\/S0140-6736(02)11995-7","article-title":"Pringle manoeuvre in living donor.","volume":"360","author":"Imamura","year":"2002","journal-title":"Lancet"},{"issue":"3","key":"R11-11-20250326","doi-asserted-by":"crossref","first-page":"36975","DOI":"10.1097\/00000658-199903000-00010","article-title":"Continuous vs. intermittent portal triad clamping for liver resection: a controlled study.","volume":"229","author":"Belghiti","year":"1999","journal-title":"Ann Surg"},{"key":"R12-11-20250326","first-page":"160166","article-title":"Hepatic ischemia-reperfusion injury.","volume":"81","author":"Serracino-Inglott","year":"2001","journal-title":"Am J Surg"}],"container-title":["Liver Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flt.20071","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flt.20071","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01445473-200402000-00011","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,29]],"date-time":"2025-03-29T09:21:00Z","timestamp":1743240060000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01445473-200402000-00011"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,2]]},"references-count":12,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2004]]}},"URL":"https:\/\/doi.org\/10.1002\/lt.20071","relation":{},"ISSN":["1527-6465"],"issn-type":[{"value":"1527-6465","type":"print"}],"subject":[],"published":{"date-parts":[[2004,2]]}}}