Outflow vein venoplasty of left lateral section graft for living donor liver transplantation in infant recipients

Abstract

Pediatric LT is often indicated for infants with biliary atresia and various other diseases. Because LT for very young infants is technically demanding, and post-transplant outcomes are relatively poor, LT is often delayed if possible until the recipient achieves a body weight of 10 kg or reaches age of 10 months. Donors with a small-sized LLS are preferentially selected to achieve an adequate GRWR. 1,2 Most LLS grafts have a single LHV trunk with preservation of the MHV trunk at the donor side. If the LLS graft is small, the LHV trunk will also be

Funneling venoplasty for anomalous graft left hepatic vein in living donor liver transplantation using a split left lateral section graft for an infant patient

“…Thus, LLS grafts usually only have the LHV trunk. If the graft LHV orifice is unsuitable for direct anastomosis, it is necessary to use customized venoplasty of the graft LHV to prevent graft hepatic vein outflow obstruction (HVOO) [1,7].…”

Tailored techniques of graft outflow vein reconstruction in pediatric liver transplantation at Asan Medical Center

“…LLS grafts can be divided into four groups, based on the type of donor surgery (open or laparoscopic) and the presence or absence of a superficial LHV branch (Fig. 4) [11].…”

“…6). If the graft LHV orifice per se appears to be large enough (≥2 cm for infant recipients), venoplasty is not performed [11].…”

“…For a laparoscopically-recovered LLS graft, a small in- cision is made at the medial end of the LHV orifice in the absence of a superficial LHV branch or at this branch if it is present, and then a circumferential vein patch is attached because the graft LHV stump is usually too short to anastomose directly (Fig. 7) [7,11].…”

Living donor liver transplantation in a pediatric patient with hepatic angiosarcoma: a case report

“…A left lateral section graft weighing 280 g was harvested from his 38-year-old father. The graft left hepatic vein orifice was enlarged with patch venoplasty according to our institutional guidelines [7,8].…”