Innovative techniques for and results of portal vein reconstruction in living-related liver transplantation

Marwan, Ibrahim; Fawzy, Ahmed Tarek I.; Egawa, Hiroto; Inomata, Yukihiro; Uemoto, Shinji; Asonuma, Katsuhiro; Kiuchi, Tetsuya; Hayashi, Michihiro; Fujita, Shiro; Ogura, Yutaka; Tanaka, Kōichi

doi:10.1067/msy.1999.95114

Cited by 3 publications

(1 citation statement)

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“…Hypoplasia of the PV often occurs in pediatric patients with biliary atresia. Various surgical techniques have been developed to reconstruct such stenotic PVs, but these techniques resulted in a non-negligible incidence of PV complications [8][9][10][11]. For sclerotic PVs with a very small caliber, longitudinal patch venoplasty is often insufficient, even after applying an extended incision into the superior mesenteric vein (SMV)-splenic vein (SV) confluence.…”

Section: Tadpole Vein Homograft Conduit Interposition For Hypoplastic Portal Vein In Infant Patients Undergoing Split or Living Donor Ltmentioning

confidence: 99%

Tailored standardization of portal vein reconstruction for pediatric liver transplantation at Asan Medical Center

Hwang

Namgoong

2021

Ann Liver Transplant

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Section: Tadpole Vein Homograft Conduit Interposition For Hypoplastic Portal Vein In Infant Patients Undergoing Split or Living Donor Ltmentioning

confidence: 99%

Tailored standardization of portal vein reconstruction for pediatric liver transplantation at Asan Medical Center

Hwang

Namgoong

2021

Ann Liver Transplant

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Risk factors for intraoperative portal vein thrombosis in pediatric living donor liver transplantation

Cheng¹,

Chen

Huang³

et al. 2004

Clinical Transplantation

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Pathologic changes of the recipient native portal venous system may cause thrombosis of the portal vein, especially in pediatric living donor liver transplantation (LDLT). This study assessed the utility of Doppler ultrasound (US) for the detection of intraoperative portal vein occlusion and identification of predisposing risk factors in the recipients. Seventy-three pediatric recipients who underwent LDLT at Chang Gung Memorial Hospital, Taiwan, from 1994 to 2002 were included. Preoperative and intraoperative Doppler US evaluation of the portal vein was performed. Age, body weight, native liver disease, type of graft, graft recipient weight ratio (GRWR), type of portal anastomosis, portal velocity, portal venous size and presence of portosystemic shunt were analyzed for statistical significance of predisposing risk factors. Eight episodes of intraoperative portal vein thrombosis, with typical findings of absent Doppler flow in portal vein and prominent hepatic artery with a resistant index lower than 0.5 (p < 0.001), were detected during transplantation, which was then corrected by thrombectomy and re-anastomosis. Children age < or =1 yr (p = 0.025), weight < or =10 kg (p = 0.024), low portal flow < or =7 cm/s (p = 0.021), portal venous size < or =4 mm (p = 0.001), and GRWR >3 (p < 0.017) were all risk factors for intraoperative portal vein thrombosis. Doppler US is essential in the preoperative evaluation, early detection and monitoring of outcome of the portal vein in liver transplant.

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The use of a composite graft of iliac artery and inferior mesenteric vein in liver transplantation

Fink

Jones

2006

Transplant Int

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Summary Innovation may be required for satisfactory arterial reconstruction in liver transplantation, particularly when the vessels obtained from the donor are inadequate. We have used a composite graft of donor iliac artery and recipient inferior mesenteric vein (IMV) between the infrarenal aorta and donor hepatic artery. Postoperative liver function was satisfactory, with normal daily duplex ultrasound scans for the first 2 weeks. At 4 years follow up, graft function is normal, a duplex ultrasound scan shows normal arterial flow and no dilatation of the composite graft, and a magnetic resonance angiogram reveals no evidence of dilatation or thrombosis of the composite graft. This is one of the few reported cases in which a composite graft has been used to arterialize the allograft in liver transplantation. A composite graft of iliac artery and IMV provided a satisfactory outcome in this patient and may be a valuable addition to the arterial grafts available to the liver transplant surgeon.

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Innovative techniques for and results of portal vein reconstruction in living-related liver transplantation

Abstract: Our innovative techniques should be helpful for overcoming diameter or length mismatches in portal vein reconstruction in pediatric liver transplantation.

Cited by 3 publications

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Tailored standardization of portal vein reconstruction for pediatric liver transplantation at Asan Medical Center

Tailored standardization of portal vein reconstruction for pediatric liver transplantation at Asan Medical Center

Risk factors for intraoperative portal vein thrombosis in pediatric living donor liver transplantation

The use of a composite graft of iliac artery and inferior mesenteric vein in liver transplantation

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