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New hepatic vein reconstruction in left liver graft
Author(s) -
Takemura Nobuyuki,
Sugawara Yasuhiko,
Hashimoto Takuya,
Akamatsu Nobuhisa,
Kishi Yoji,
Tamura Sumihito,
Makuuchi Masatoshi
Publication year - 2005
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.20374
Subject(s) - medicine , anastomosis , liver transplantation , vein , stenosis , right gastric vein , surgery , radiology , transplantation , portal venous pressure , portal hypertension , cirrhosis
The incidence of hepatic venous stenosis is higher in partial liver transplantation. New methods for hepatic venous reconstruction in left liver transplantation, which secure wide anastomosis, were devised and are reported here. In the graft, the right side of the middle hepatic vein or the left side of the left hepatic vein was cut longitudinally and a rectangular‐shaped vein patch was attached for venoplasty. In the recipient, after the left and middle hepatic veins were joined, the right side of the middle hepatic vein was cut toward the closed right hepatic vein, making a horizontal cavotomy for anastomosis. Of 92 patients who underwent conventional hepatic vein reconstruction, 3 were complicated by hepatic venous stenosis (median follow‐up 43 months). By contrast, there were no hepatic vein complications in the 20 patients who underwent the new technique (7 months). The current method appears to be technically feasible for outflow reconstruction in left liver graft transplantation. (Liver Transpl 2005;11:356–360.)