Minich A. Reconstruction of hepatic veins in transplantation of the liver right lobe from a living related donor

The dissertation contains new approaches to the selection of the type of transplantation of the right lobe of the liver from a living related donor, based on an anatomically sound approach. X-ray anatomical variants of the vein structure of the right lobe of 76 donors were studied, on the basis of which 3 types of venous outflow from the right lobe of the liver were identified: dominant right hepatic vein, dominant middle hepatic vein and evenly distributed type of outflow. An algorithm for selecting a transplant of the right lobe of the liver from a living family donor has been developed, depending on the anthropometric indicators of the donor and the recipient, the standard estimated volume of the liver, and the type of venous outflow from the right lobe of the liver. It is established that the application of the developed algorithm, with anatomical possibility, transplantation of the right lobe of the liver from a living related donor with the inclusion of the middle hepatic vein allows to provide increased portal inflow to the transplant, and as a consequence to improve its functional properties, which allows to reduce the “small for size transplant syndrome”, postoperative mortality and length of stay in hospital.