{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T21:27:37Z","timestamp":1761514057835},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","license":[{"start":{"date-parts":[[2017,11,8]],"date-time":"2017-11-08T00:00:00Z","timestamp":1510099200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2017,11,8]],"date-time":"2017-11-08T00:00:00Z","timestamp":1510099200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver Transpl"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:p>Living donor liver transplantation using the left liver graft with the middle hepatic vein (MHV) is a well\u2010established procedure. Following such procedures, outflow obstruction occurs in remnant livers. However, the effects of the outflow\u2010obstructed liver volume (LV<jats:sub>Out\u2010Ob<\/jats:sub>), with or without venous communication development, remain unclear. The aim of the study is to investigate effects of outflow\u2010obstructed regions by focusing on short\u2010term outcomes and remnant liver hypertrophy in left liver procurement donors. Of 532 donors, we collected data from 119 undergoing left liver procurement with the MHV. Postoperative hepatic parameters, venous communication development, and liver hypertrophy were evaluated in 2 donor groups based on LV<jats:sub>Out\u2010Ob<\/jats:sub>. The left liver was procured with the MHV in 119 donors, who formed 2 more groups based on the median LV<jats:sub>Out\u2010Ob<\/jats:sub>: large\u2010outflow\u2010obstruction group (n\u2009=\u200960; LV<jats:sub>Out\u2010Ob<\/jats:sub>\u2009\u2265\u2009263\u2009mL) and small\u2010outflow\u2010obstruction (n\u2009=\u200959; LV<jats:sub>Out\u2010Ob<\/jats:sub>\u2009&lt;\u2009263\u2009mL) group. Postoperative liver function parameters were significantly impaired in the large\u2010outflow\u2010obstruction group compared with the small\u2010outflow\u2010obstruction group. Postoperative venous communication developed in 52 (66.7%) of 78 donors analyzed. Hypertrophy ratios in remnant right livers and right paramedian sectors were significantly higher in the small\u2010outflow\u2010obstruction group than in the large\u2010outflow\u2010obstruction group (<jats:italic toggle=\"yes\">P<\/jats:italic>\u2009=\u20090.01 and <jats:italic toggle=\"yes\">P<\/jats:italic>\u2009=\u20090.02, respectively). The liver hypertrophy ratio of outflow\u2010obstructed regions was better, especially in small regions developing venous communication (<jats:italic toggle=\"yes\">P\u2009=\u2009<\/jats:italic> 0.001). The postoperative morbidity rate did not differ significantly (<jats:italic toggle=\"yes\">P<\/jats:italic>\u2009=\u20090.66). In conclusion, the procurement of the left liver graft with the MHV was safely performed with minimal morbidity by assessing the donor remnant right liver volume with and without outflow obstruction. Attention should be paid that postoperative hepatic parameters and remnant liver hypertrophy were impaired in the remnant livers with large outflow\u2013obstructed regions compared with those with small outflow\u2013obstructed regions. <jats:italic toggle=\"yes\">Liver Transplantation 23 1531\u20131540 2017<\/jats:italic> AASLD.<\/jats:p>","DOI":"10.1002\/lt.24849","type":"journal-article","created":{"date-parts":[[2017,8,17]],"date-time":"2017-08-17T16:02:43Z","timestamp":1502985763000},"page":"1531-1540","source":"Crossref","is-referenced-by-count":6,"title":["Influence of outflow\u2010obstructed liver volume and venous communication development: A three\u2010dimensional volume study in living donors"],"prefix":"10.1097","volume":"23","author":[{"given":"Yoshikuni","family":"Kawaguchi","sequence":"first","affiliation":[{"name":"Divisions of Hepato\u2010Biliary\u2010Pancreatic Surgery"},{"name":"Artificial Organ and Transplantation Surgery, Department of Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiyoshi","family":"Hasegawa","sequence":"additional","affiliation":[{"name":"Divisions of Hepato\u2010Biliary\u2010Pancreatic Surgery"},{"name":"Artificial Organ and Transplantation Surgery, Department of Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoki","family":"Okura","sequence":"additional","affiliation":[{"name":"Department of Radiology, Graduate School of Medicine,The University of Tokyo,Tokyo,Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harufumi","family":"Maki","sequence":"additional","affiliation":[{"name":"Divisions of Hepato\u2010Biliary\u2010Pancreatic Surgery"},{"name":"Artificial Organ and Transplantation Surgery, Department of Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobuhisa","family":"Akamatsu","sequence":"additional","affiliation":[{"name":"Divisions of Hepato\u2010Biliary\u2010Pancreatic Surgery"},{"name":"Artificial Organ and Transplantation Surgery, Department of Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junichi","family":"Kaneko","sequence":"additional","affiliation":[{"name":"Divisions of Hepato\u2010Biliary\u2010Pancreatic Surgery"},{"name":"Artificial Organ and Transplantation Surgery, Department of Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junichi","family":"Arita","sequence":"additional","affiliation":[{"name":"Divisions of Hepato\u2010Biliary\u2010Pancreatic Surgery"},{"name":"Artificial Organ and Transplantation Surgery, Department of Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshihiro","family":"Sakamoto","sequence":"additional","affiliation":[{"name":"Divisions of Hepato\u2010Biliary\u2010Pancreatic Surgery"},{"name":"Artificial Organ and Transplantation Surgery, Department of Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuni","family":"Ohtomo","sequence":"additional","affiliation":[{"name":"Department of Radiology, Graduate School of Medicine,The University of Tokyo,Tokyo,Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norihiro","family":"Kokudo","sequence":"additional","affiliation":[{"name":"Divisions of Hepato\u2010Biliary\u2010Pancreatic Surgery"},{"name":"Artificial Organ and Transplantation Surgery, Department of Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2017,11,8]]},"reference":[{"key":"lt24849-bib-0001-20240115","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1097\/TP.0b013e3181aaccb0","article-title":"Donor complications associated with living donor liver transplantation in Japan","volume":"88","year":"2009","journal-title":"Transplantation"},{"key":"lt24849-bib-0002-20240115","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1111\/j.1477-2574.2012.00475.x","article-title":"Is left lobe adult\u2010to\u2010adult living donor liver transplantation ready for widespread use? 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