Diamond-shaped patch technique for right hepatic vein reconstruction in living-donor liver transplant: A simple method to prevent stenosis.

Abstract:

:Patency of the right hepatic vein (RHV) of the liver graft is essential for successful living-donor liver transplant (LDLT). We developed a simple technique for RHV reconstruction that does not require the use of cadaveric veins or additional time to prevent stenosis.Of 159 patients who underwent LDLT at our institution between May 2010 and April 2016, we included 152 in this study. Conventional RHV reconstruction was performed in 100 patients, while the diamond-shaped patch (D-patch) technique was performed in 53. For the D-patch technique, the posterior aspect of the RHV needs to be dissected from the liver parenchyma during donor hepatectomy, which prevents stenosis due to liver rotation after graft regeneration. A D-patch obtained from the hepatic vein of the recipient liver was used on the anterior aspect of the RHV for reconstruction. The Student's t test and χ test were used for statistical analysis.Rates of intervention for RHV stenosis during the first month were significantly different between the conventional reconstruction and D-patch groups (19.2% vs 3.8%; P = .01). The time taken to perform the D-patch technique was similar to that for conventional reconstruction (anhepatic period, 104.9 ± 47.3 minutes vs 106.7 ± 42.0 minutes; P = .82).The D-patch technique for RHV reconstruction in LDLT is a simple, fast, and feasible surgical technique that can be performed without using cadaveric or saphenous veins.

journal_name

Medicine (Baltimore)

journal_title

Medicine

authors

Lee TB,Choi BH,Yang KH,Ryu JH,Park YM,Chu CW

doi

10.1097/MD.0000000000011815

subject

Has Abstract

pub_date

2018-08-01 00:00:00

pages

e11815

issue

34

eissn

0025-7974

issn

1536-5964

pii

00005792-201808240-00022

journal_volume

97

pub_type

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