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Modified triangular hepatic vein reconstruction for preventing hepatic venous outflow obstruction in pediatric living donor liver transplantation using left lateral segment grafts
Author(s) -
Fukuda Akinari,
Sakamoto Seisuke,
Sasaki Kengo,
Narumoto Soichi,
Kitajima Toshihiro,
Hirata Yoshihiro,
Hishiki Tomoro,
Kasahara Mureo
Publication year - 2018
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.13167
Subject(s) - medicine , anastomosis , vein , liver transplantation , surgery , living donor liver transplantation , constriction , transplantation , radiology
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 LDLT s 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 .