The benefit of cholangiography during the ex-vivo split procedure in deceased donor liver transplantation

Abstract

The patient was a 38-year-old woman who was diagnosed with primary biliary cholangitis at the age of 33. As her liver function gradually worsened, she was registered as a recipient candidate of deceased donor liver transplantation (DDLT). Three months after registration, split liver grafts from a male deceased donor were transplanted to her and a child recipient. The liver graft was divided into a left lateral segment graft for the child recipient and a right extended liber lobe graft for her. Before liver splitting, we examined the cholangiography of the whole liver graft. The results of the cholangiography clearly demonstrated an anatomical feature about branching of the right posterior sector. On the basis of this result, we divided the liver on the back table (ex-situ). After liver splitting by the clamp crushing method, the liver graft was transferred and transplanted to the recipients without any biliary complications. Intraoperative cholangiography during graft harvesting is suggested to be useful for the safety and efficiency of donor operation.