Sakuraoka Y, Seth R, Boteon AP, Perrin M, Isaac J, Subash G, Muiesan P, Schlegel A. Large Riedel’s lobe and atrophic left liver in a donor - Accept for transplant or call off? World J Transplant 2020; 10(5): 129-137 [PMID: 32864358 DOI: 10.5500/wjt.v10.i5.129]
Corresponding Author of This Article
Andrea Schlegel, MD, Associate Research Scientist, NIHR Liver Biomedical Research Unit, University Hospitals Birmingham, Mindelsohn Way, Birmingham B15 2TH, United Kingdom. andrea.schlegel@uhb.nhs.uk
Research Domain of This Article
Transplantation
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Transplant. May 29, 2020; 10(5): 129-137 Published online May 29, 2020. doi: 10.5500/wjt.v10.i5.129
Large Riedel’s lobe and atrophic left liver in a donor - Accept for transplant or call off?
Yuhki Sakuraoka, Rashmi Seth, Amanda PCS Boteon, Moira Perrin, J Isaac, Gowri Subash, Paolo Muiesan, Andrea Schlegel
Yuhki Sakuraoka, Rashmi Seth, Amanda PCS Boteon, Moira Perrin, J Isaac, Gowri Subash, Paolo Muiesan, Andrea Schlegel, The Liver Unit, Queen Elizabeth University Hospital Birmingham, Birmingham B15 2TH, United Kingdom
Yuhki Sakuraoka, Second Department of Surgery, Dokkyo Medical University, Tokyo 321-0293, Japan
Paolo Muiesan, Andrea Schlegel, NIHR Liver Biomedical Research Unit, University Hospitals Birmingham, Birmingham B15 2TH, United Kingdom
Author contributions: Sakuraoka Y and Schlegel A designed research; Sakuraoka Y, Seth R, Muiesan P and Schlegel A performed research; Seth R, Boteon APCS, Perrin M, and Subash G contributed new reagents or analytic tools; Sakuraoka Y, Isaac J, Subash G, Muiesan P, and Schlegel A analyzed data; Sakuraoka Y, Muiesan P, and Schlegel A wrote the paper.
Informed consent statement: The informed consent statement has been signed by patients.
Conflict-of-interest statement: All other authors have nothing to disclose.
CARE Checklist (2016) statement: The manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Andrea Schlegel, MD, Associate Research Scientist, NIHR Liver Biomedical Research Unit, University Hospitals Birmingham, Mindelsohn Way, Birmingham B15 2TH, United Kingdom. andrea.schlegel@uhb.nhs.uk
Received: January 5, 2020 Peer-review started: January 5, 2020 First decision: February 20, 2020 Revised: March 18, 2020 Accepted: May 12, 2020 Article in press: May 12, 2020 Published online: May 29, 2020 Processing time: 144 Days and 8.6 Hours
Abstract
BACKGROUND
In context of suboptimal liver utilisation, grafts with various risk factors are under consideration today. For example, impaired vascularity with severe arterial calcifications and modified liver shapes are no longer contraindications and their use depends on the centre policy and experience of the surgical team. Riedel liver lobes represent a tongue-like liver shape with inferior projection in the right liver lobe. Such development modifications were initially described when patients developed a lesion and subsequently presented with symptoms. We here present the first case report in the literature, where such livers with anatomical variations were used for transplantation.
CASE SUMMARY
We describe here two cases of adult human liver transplantation, where we have accepted two donor livers with modified shape. The technical considerations for transplantation of such livers, found with enlarged right lobes, or Riedel shape, and hypo-trophic left lateral segment are highlighted. Both recipients experienced immediate liver function and overall good outcomes with a minimum follow up of 1 year. We also provide detailed pictures and outcome analysis in combination with a literature review.
CONCLUSION
The utilisation of donor livers with modified shape, such as Riedel’s Lobe appears safe and will increase the donor pool.
Core tip: To the best of our knowledge, this will be the first report on utilisation of large right Riedel’s liver lobes with further anatomical modifications for liver transplantation. We highlight donor and recipient risk factors and focus parameters with impact on recipient selection and on technical aspects for implantation. Additionally, we combine our case series with current available literature in this field.
