Usability of Inferior Vena Cava Interposition Graft During Living Donor Liver Transplantation: Is This Approach Always Necessary?

Inferior Vena Cava Constriction After Liver Transplantation Is a Severe Complication Requiring Individually Adapted Treatment: Report of a Single-Center Experience

“…The Korean standardization of right-lobe LDLT suggests preservation of retro-hepatic IVC and unification venoplasty techniques for reconstruction of the inferior right hepatic vein [ 42 ], which was likewise performed in our center. Venous augmentation is frequently performed in highly experienced LDLT centers [ 41 , 43 , 44 ], and PTFE grafts [ 41 , 43 ] or homologous vascular grafts [ 43 , 45 ] can be used. Although remaining a rare complication after LDLT, IVC stenosis can be successfully treated by PTA [ 44 ].…”

Comment on a new treatment strategy for end-stage hepatic alveolar echinococcosis: IVC resection without reconstruction

“…Resection and reconstruction of retrohepatic IVC can be performed under special circumstances. However, in certain hematologic diseases which cause chronic thrombus and occlusion of the retrohepatic IVC, wide iatrogenic defect of the IVC during surgical procedures, chronic liver disease causing a difficult dissection plane around the IVC, hepatic malignancies resulting in a massive invasion of IVC that obscures R0 resection, and HAE disease invading or causing dense fibrosis around IVC prevent any reconstructive effort [2] .…”

“…The necessity of IVC reconstruction following the formation of extensive tissue defects after resection depends totally on the duration of obstruction (whether chronic or not) and presence of effective venous collateral circulation (azygos, hemiazygos, ascending lumbar veins, big portosystemic collaterals) [2] , [3] . If the venous collaterals are well developed; such as the 13 patients presented in the present study; no pressure gradient will be observed around the stenotic-thrombotic IVC segment.…”

“…According to the current literature, there is no consensus regarding the choice of the ideal vascular graft material for IVC reconstruction but alternatives include cryopreserved homologous vascular grafts (including the aorta, iliac artery, iliac vein, IVC) or artificial vascular grafts (including Dacron, PTFE) [2] , [3] . The problems such as thrombosis and infection (which was the argument of the authors, as well) are commonly seen with the use of artificial vascular grafts and therefore, it is suggested that cryopreserved homologous vascular grafts should be preferred for IVC reconstruction; whenever possible.…”

Comment on “Portal vein thrombosis in patients with liver cirrhosis and its impact on early and long‐term outcomes after liver transplantation”

“…should be given such that the INR level is between 2 and 2.5 before discharged. 2,3 5. The authors stated that the categorical variables of the PVT (+) and PVT (-) groups are summarised in Table- 8.…”