Extracorporeal suture technique for suprahepatic caval anastomosis in liver transplantation.

Abstract:

BACKGROUND:During liver transplantation, an oversized graft or active bleeding in the hepatic area can make performance of the suprahepatic caval anastomosis extremely difficult or even impossible. In other instances, a brief as possible warm ischemia is desired to provide a marginal graft with maximum chances of good functioning. METHODS:In order to manage those conditions, a suture technique was devised that allows the construction of a substantial part of the suprahepatic caval anastomosis keeping the graft outside the abdomen of the recipient. RESULTS:Over a 12-month period, the technique was applied in 7 out of 148 transplants (5%). The 7 cases presented one or more of the following conditions: significant oversize mismatch (n = 6), active bleeding in the hepatic area (n = 1), and marginal graft (n = 4). Warm ischemia time averaged 27 minutes, a value not significantly different from the mean warm ischemia time of 25 minutes recorded in the easier transplants in which the conventional technique was used (P = 0.2467). CONCLUSIONS:This extracorporeal suture technique allows construction of the suprahepatic caval anastomosis in critical situations arising during liver transplantation and avoidance of the prolonged warm ischemia that could be expected in such cases.

journal_name

Am J Surg

authors

Salizzoni M,Romagnoli R,Zamboni F

doi

10.1016/s0002-9610(01)00875-3

subject

Has Abstract

pub_date

2002-02-01 00:00:00

pages

156-9

issue

2

eissn

0002-9610

issn

1879-1883

pii

S0002961001008753

journal_volume

183

pub_type

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