Modified triangular hepatic vein reconstruction for preventing hepatic venous outflow obstruction in pediatric living donor liver transplantation using left lateral segment grafts

Pediatric Transplantation
Akinari FukudaMureo Kasahara

Abstract

HVOO can be a critical complication in pediatric LDLT. The aim of this study was to evaluate a modified triangular technique of hepatic vein reconstruction for preventing HVOO in pediatric LDLT. A total of 298 pediatric LDLTs were performed using a left lateral segment graft by 2 methods for reconstruction of the hepatic vein. In 177 recipients, slit-shaped anastomosis was indicated with partial clamp of the IVC. A total of 121 recipients subjected to the modified triangular anastomosis with total clamp of the IVC. We compared the incidence of hepatic vein anastomotic complications between these 2 methods. Nine of the 177 cases (5.3%) treated with the conventional technique were diagnosed with outflow obstruction. All 9 cases underwent hepatic vein reconstruction with the slit-shaped hepatic vein anastomosis. In contrast, there were no cases of outflow obstruction in the 121 cases treated with the modified triangular anastomosis. The modified triangular technique of hepatic vein reconstruction with total clamping of the IVC was useful for preventing HVOO in pediatric LDLT.

References

Nov 1, 2002·Annals of Surgery·Joseph F BuellJ Michael Millis
Mar 28, 2003·Surgery·Milan M KinkhabwalaJean C Emond
Feb 17, 2010·Pediatric Surgery International·G Krishna KumarA J W Millar
Dec 6, 2011·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Shin HwangSung-Gyu Lee
Jul 22, 2014·Pediatric Transplantation·Jean C Emond, Jean de Ville de Goyet
Apr 25, 2015·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Shirin Elizabeth KhorsandiNigel Heaton
Jul 29, 2016·World Journal of Gastroenterology : WJG·Omar Abdelaziz, Hussein Attia

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Citations

Jan 30, 2019·Current Opinion in Organ Transplantation·Priyal Patel, Joseph DiNorcia
Sep 9, 2020·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Sung Woo AhnKyung-Suk Suh

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