Right Lateral Sector Graft in Adult Living-Related Liver Transplantation1

BACKGROUND: A major concern regarding adult living-related liver transplantation (LRLT) is graft-size disparity. The authors report their experience with LRLT using the right lateral sector. PATIENTS AND METHODS: Between January 2000 and April 2001, 32 adult-to-adult LRLTs were performed at our institution. Of these, six patients received a right lateral sector (RLS, segments VI and VII according to Couinaud's nomenclature for liver segmentation) graft. The right liver was over 70% of the estimated volume of the whole donor liver. The estimated RLS volume was greater than that of the left liver, which was over 40% of the recipient's standard liver volume. RESULTS: The postoperative course was uneventful in all donors. All of the patients survived the operation. Three patients were complicated with bile leakage from the dissection plane of the graft. Four patients suffered from acute rejection. CONCLUSIONS: RLS graft obtained by this procedure may be useful for overcoming borderline graft-recipient size differences and expanding the donor pool.