Korean J Transplant.  2023 Nov;37(Suppl 1):S286. 10.4285/ATW2023.F-9029.

Left at right heterotopic implantation of left liver graft in adult-to-adult living donor liver transplantation: the technical concern for decision-making

  • 1Department of Liver Transplantation and Hepatobiliary Surgery, Catholic University of Daegu, Daegu, Korea


Left liver graft is important role in living donor liver transplantation in aspect of donor safety. However, conventional implantation technique of left liver graft is technically demanding and has potential risk for inferior vena cava compression, or inflow, outflow and bile duct kinking related to liver graft position. We have two cases of left at right heterotopic implantation of left liver graft and compare with conventional left liver implantation technique.
From March 2022 to March 2023, we performed 33 cases of living donor liver transplantation and two cases of deceased donor liver transplantation. There were four cases of left liver graft, two were conventional technique and two were heterotopic technique. Three cases were living donor liver transplantation and one case was deceased donor split liver transplantation.
There was no immediate postoperative complication, discharged without adverse event. Biliary complication was occurred in conventional implantation technique with living donor left graft and resolved using percutaneous biliary drainage.
Left liver graft has advantage in donor safety and heterotopic implantation technique of left liver graft could solve potential risk of left liver graft. However, conventional technique should be performed in graft with long lateral segment or large graft volume. Therefore, thorough preoperative evaluation is essential for decision making.

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