Ultrasound images of the liver and spleen show regeneration of the liver with the left lobe of liver fully grown to fill the defect in the liver. The left lobe is seen extending all the way to the spleen.
What are the important points?
Live liver donation of the left lobe of the liver is a major surgical procedure that involves the removal of a large portion of the liver from a healthy donor for transplantation into a recipient. The liver is the only organ in the body that has the capacity to regenerate after partial removal, and the remaining liver tissue will grow to compensate for the removed portion. However, the long-term effects of live liver donation on the spleen, portal vein, and splenic vein may vary from person to person.Regarding the spleen, live liver donation can cause a transient increase in spleen size due to increased blood flow through the splenic vein, which drains into the portal vein. This increase in spleen size is usually temporary and resolves within a few weeks after the surgery. However, in rare cases, the spleen can become enlarged permanently, leading to a condition called hypersplenism, which may require treatment.
The portal vein is a major blood vessel that carries blood from the digestive organs to the liver. Live liver donation may cause mild to moderate dilation of the portal vein due to increased blood flow through the vessel. However, this dilation is usually transient and resolves within a few months after the surgery. Mild dilation of the portal vein at 14 mm, seven years after donation, is not likely to be clinically significant or require treatment.
The splenic vein is another blood vessel that drains blood from the spleen and other abdominal organs to the liver. Live liver donation can cause narrowing or occlusion of the splenic vein, which may lead to splenic vein thrombosis. However, this complication is rare, occurring in less than 1% of cases, and is usually asymptomatic.
Fatty liver is a condition in which there is an excessive accumulation of fat in the liver cells. It is common in the general population and can be caused by various factors such as obesity, diabetes, and alcohol consumption. Fatty liver can also occur after live liver donation, although the exact prevalence is unknown. It is usually asymptomatic and does not require specific treatment unless it progresses to more severe liver disease such as cirrhosis.
In summary, live liver donation of the left lobe of the liver can have various effects on the spleen, portal vein, and splenic vein, which may vary from person to person. However, in most cases, these effects are temporary and do not cause significant health problems. Mild dilation of the portal vein and fatty liver, seven years after donation, are not likely to be clinically significant but should be monitored for any potential progression or complications.
Why is the left lobe of liver used in liver donation?
Live liver donation is a surgical procedure in which a living person donates a portion of their liver to a recipient in need of a liver transplant. The liver is a unique organ that can regenerate itself, which makes live liver donation possible. In most cases, the left lobe of the liver is used for donation.
The left lobe of the liver is preferred for donation because it is smaller and easier to remove than the right lobe. The left lobe is responsible for about 40% of the liver's function, which is usually sufficient to meet the needs of the recipient. The right lobe, on the other hand, is larger and more complex, and its removal can lead to a higher risk of complications for the donor.
The use of the left lobe for donation has several advantages. First, it allows for a smaller incision and shorter surgery time, which can reduce the risk of complications for the donor. Second, the left lobe can regenerate quickly, and the remaining liver can compensate for the missing part within a few months. Third, the use of the left lobe can increase the number of potential donors, as more people are eligible for donation.
What are the ultrasound findings immediately after liver donor surgery?
Immediately after liver donation, the ultrasound imaging of the liver shows a decrease in size of the liver. This is expected since a part of the liver has been removed. The remaining liver compensates for the missing part and gradually increases in size. The immediate postoperative ultrasound may show some fluid accumulation around the liver, which is a common finding after any surgical procedure. The fluid accumulation usually resolves on its own within a few days.
One common complication that can occur after liver donation is the development of fatty liver disease. Fatty liver disease is a condition in which excess fat accumulates in the liver cells. This can lead to inflammation and scarring of the liver, which can affect its function. Studies have shown that up to 50% of liver donors develop fatty liver disease within the first year after donation. However, most cases are mild and do not cause any significant symptoms. The risk of developing fatty liver disease can be reduced by maintaining a healthy diet and lifestyle.
What are the changes in the long term?
Seven years after liver donation, the liver has regenerated to its original size, and the ultrasound imaging of the liver shows no signs of any residual fluid accumulation. The liver appears to be healthy, with no evidence of any focal lesions or masses. However, the presence of fatty liver disease may still be seen on ultrasound. In some cases, the fatty liver may have progressed to a more severe stage, such as non-alcoholic steatohepatitis (NASH), which can lead to liver fibrosis and cirrhosis if left untreated.
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