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Simplified one‐orifice venoplasty for middle hepatic vein reconstruction in adult living donor liver transplantation using right lobe grafts
Author(s) -
Kim Joo Dong,
Choi Dong Lak,
Han Young Seok
Publication year - 2014
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12355
Subject(s) - medicine , vein , surgery , living donor liver transplantation , liver transplantation , stenosis , lobe , body orifice , transplantation , retrospective cohort study , radiology , anatomy
Middle hepatic vein ( MHV ) reconstruction is often essential to avoid hepatic congestion and serious graft dysfunction in living donor liver transplantation ( LDLT ). The aim of this report was to introduce evolution of our MHV reconstruction technique and excellent outcomes of simplified one‐orifice venoplasty. We compared clinical outcomes with two reconstruction techniques through retrospective review of 95 recipients who underwent LDLT using right lobe grafts at our institution from January 2008 to April 2012; group 1 received separate outflow reconstruction and group 2 received new one‐orifice technique. The early patency rates of MHV in group 2 were higher than those in group 1; 98.4% vs. 88.2% on postoperative day 7 (p = 0.054) and 96.7% vs. 82.4% on postoperative day 14, respectively (p = 0.023). Right hepatic vein ( RHV ) stenosis developed in three cases in group 1, but no RHV stenosis developed because we adopted one‐orifice technique (p = 0.043). The levels of aspartate aminotransferase ( AST ) and alanine aminotransferase ( ALT ) in group 2 were significantly lower than those in group 1 during the early post‐transplant period. In conclusion, our simplified one‐orifice venoplasty technique could secure venous outflow and improve graft function during right lobe LDLT .