An Alternative Method of Reconstruction of Hepatic Venous Outflow in Domino Liver Transplantation

Domino-liver transplantation: toward a safer and simpler technique in both donor and recipient

“…It is of note that eight patients presented a venous outflow obstruction and that six patients needed to be re-transplanted [16]. The fact that 16 more technical modifications have been reported during the period 2001-2019 indicates the need for further standardization and simplification of the technique [8,28,[31][32][33][34][35][36][37][38][39][40][41][42][43][44][45]. The venous outflow reconstruction of the domino-graft, such as described here, is in line with this.…”

Alternative outflow reconstruction in domino liver transplantation

“…However, in order to achieve these good results, it is necessary to have an adequate vascular graft. Like Suarez-Munoz et al, (5) we used the iliac vein because it was the single vascular graft available. The main difference is that the Suarez-Munoz method uses both common iliac veins of the donor, and we only use a single iliac graft that we cut in length to fit the diameter of the HV stump so that we do not need to perform a septoplasty also.…”

“…If this is the case, then HV reconstruction is mandatory. Many different technical resources have been described, from a classic technique with cava resection and venousvenous bypass, to reconstruction with a cava patch, (1) an iliac bifurcation graft, (2) venoplasty with a venous patch (3) or arterial patch, (4) or performing a neocaval segment using both common iliac veins, (5) among others.…”

Operative Risks of Domino Liver Transplantation for the Familial Amyloid Polyneuropathy Liver Donor and Recipient: A Double Analysis

“…To prevent hepatic outflow obstruction, an adequate caval length for both the donor as well as the FAP liver graft (to be transplanted) is necessary. As mentioned earlier, to achieve an adequate caval length several modifications have been described (27)(28)(29)(30). In our series, we did not have to use any modification to deal with the vena cava during domino LTs.…”