Living related liver transplantation in biliary atresia with absent inferior vena cava

Abstract

The success of the triangulation technique for hepatic venous anastomosis in left lateral segment liver transplantation has led to standardization of this procedure. We report a case of syndromic biliary atresia with absent inferior vena cava in which we constructed a neo cava to implant a living related left lateral segment graft by using the triangulation technique. (Liver Transpl 2001;7:376-377.)

Surgical anatomy of segmental liver transplantation

“…Finally, congenital absence of the inferior vena cava in the recipient, as seen in syndromic biliary atresia, presents unique challenges in paediatric liver transplantation. In exceptional situations, a new vena cava may be reconstructed using a cadaveric iliac vein 18 .…”

Multislice computed tomography angiography in pediatric liver transplantation

“…The standard management procedure is a transdiaphragmatic triangulation technique of left lateral segment liver transplantation in which the hepatic vein is anastomosed with the right atrium (17). Conventional CT and magnetic resonance imaging are better tools for assessing the IVC than sonography.…”

Technical Considerations in Liver Transplantation for Biliary Atresia With Situs Inversus

“…In cases where the length of the recipient HV appears insufficient despite further dissection of the diaphragm, a direct anastomosis of the graft HV and the right atrium (RA) of the recipient or the use of an interposition vein graft to construct a retrohepatic vena cava have been described. (28) To avoid kinking at the anastomotic site, sufficient dissection toward the recipient RA is required to prevent the misalignment of the graft HV and recipient RA. However, excessive dissection toward the recipient RA may cause phrenic nerve paralysis.…”