DOI: 10.1002/ame2.70121
Two-stage portal flow modulation for volume-augmented grafts in living donor liver transplantation:Rat model validation
Yuqi Gong1
Yutong Chen1
Zhoucheng Wang2
Libin Dong2
Zhengxing Lian3
Kai Wang4
Xiao Xu5
1.The Fourth School of Clinical Medicine,Zhejiang Chinese Medical University,Hangzhou,China2.Zhejiang University,School of Medicine,Hangzhou,China3.Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province,Hangzhou First People's Hospital,Hangzhou,China4.General Surgery,Cancer Center,Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery,Zhejiang Provincial People's Hospital(Affiliated People's Hospital),Hangzhou Medical College,Hangzhou,China5.Hepatobiliary Center,The First Affiliated Hospital of Nanjing Medical University,Nanjing,China;Institute of Organ Transplantation,Zhejiang University School of Medicine,Hangzhou,China
摘要：Graft procurement in adult living donor liver transplantation(LDLT)faces persistent challenges in balancing volumetric adequacy and donor safety.This study introduces two-stage portal vein ligation and reperfusion for graft procurement in LDLT(PVLR-LT),which aims to expand the left lateral lobe for achieving adequate grafts,thereby cir-cumventing technical and anatomical limitations of conventional approaches.In a rat model,the PVLR-LT group underwent selective portal vein ligation(step Ⅰ)to induce targeted hypertrophy,followed by reperfusion and transplantation(step Ⅱ).Outcomes were compared among PVLR-LT,negative controls,and standard-volume controls.Staged portal flow modulation effectively redistributed hepatic mass allocation,yield-ing grafts with graft recipient weight ratio approximately double that of negative con-trols and equivalent to standard-volume controls.Donors experienced no mortality,with only transient enzyme elevation.Recipient survival in the PVLR-LT group signifi-cantly exceeded that of the negative control group and was non-inferior to that of the standard-volume control group,while hepatic enzyme peaks were markedly lower than those in standard-volume control recipients.This study provides a promising proof of concept,establishing the feasibility of using PVLR-LT to convert the surgically straight-forward left lateral segment into right lobe-sized grafts through staged portal flow modulation and demonstrating the translational potential for laparoscopic LDLT.
机标关键词：modulationportallivingvolumedonorflowmodelaugmented
论文发表日期：2025-12-30
在线出版日期：2026-03-25（本平台首次上网日期，不代表文献的发表时间）
页数：10( 2288-2297 )
英文信息