Published online May 29, 2020. doi: 10.5500/wjt.v10.i5.129
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
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.
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.
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.