Unification venoplasty to cope with recipient portal vein anomaly during living donor liver transplantation.
Transplant Proc
; 45(8): 3000-4, 2013 Oct.
Article
em En
| MEDLINE
| ID: mdl-24157023
ABSTRACT
PURPOSE:
To cope with recipient portal vein (PV) anomalies, such as early branching of the right posterior section (RPS), during living donor liver transplantation (LDLT) surgery, we performed a simulation study to standardize the surgical technique for unification portal venoplasty.METHODS:
This study included an observational analysis of conventional methods utilizing RPS PV, simulation-based design of a new surgical technique, and clinical application of this new technique.RESULTS:
In a case encountering RPS PV, a mild anastomotic PV stenosis was persistent over 6 months postsurgery, indicating the need for technical refinement. After computational simulation analysis, we found that simple suturing of the PV branch patch automatically resulted in a funnel-shaped elongation. A prospective recipient study (n = 30) indicated that usual PV reconstruction via the PV bifurcation method is feasible in the absence of unusual donor or recipient PV anomaly. Retrospective living donor PV anatomy analysis (n = 20) revealed that 20-mm-long limbs of the first-order PV branches are necessary to make a 10- to l5-mm-long funneled PV stump. This technique of unification venoplasty for an anomalous recipient PV was applied to an adult patient undergoing LDLT with a right liver graft, for which it was shown to be technically feasible and effective.CONCLUSIONS:
A simplified unification venoplasty technique was developed to cope with a recipient PV anomaly in adult LDLT.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Veia Porta
/
Transplante de Fígado
/
Doadores Vivos
Limite:
Humans
Idioma:
En
Revista:
Transplant Proc
Ano de publicação:
2013
Tipo de documento:
Article