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TECHNICAL CHARACTERISTICS AND RESULTS OF HEPATIC VENOUS OUTFLOW RECONSTRUCTION IN LIVING DONOR LIVER TRANSPLANTATION USING RIGHT LOBE GRAFT
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Abstract
Objective: To evaluate the technical characteristics and results of hepatic venous outflow reconstruction in right lobe graft living donor liver transplantation. Subject and method: The prospective study was performed on 52 cases of living donor liver transplantation using right lobe graft at 108 Military Central Hospital from January 2019 to December 2020. Results: There were 42 cases of using the extended lobe living donor liver transplant including the middle hepatic vein (80.7%) and 10 cases of the modified right lobe graft with the middle hepatic vein reconstructed from the V5 and/ or V8 branches (19.3%) by using polytetrafluoroethylene artificial vessels. We conjoined the MHV and RHV as a single orifice hepatic vein. The hepatic veins were enlarged to the left and downwards at the orifice of the recipient's right hepatic vein, with a mean incision length of 14 mm and 9.7 mm, respectively. A total of 15/52 accessory right inferior hepatic veins with diameter > 5 mm were anastomosed directly to inferior vena cava (IVC) in an end-to-side fashion in recipient (28.8%). There were 3 cases of middle hepatic vein obstruction (2 stenoses, 1 occlusion) (5.7%). The mortality rate of hepatic venous outflow obstruction was 1,9%. Conclusion: The single orifice hepatic vein reconstruction in LDLT using a right lobe graft is a simple and feasible surgical technique, and it does not require cadaveric vessels. Most of all, it can prevent effectively HV stenosis.
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Keywords
living donor liver transplantation, hepatic venous outflow reconstruction
References
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