Outflow Reconstruction using Cryopreserved Aortic Patch in Right Lobe Living Donor Liver Transplantation

INTRODUCTION: Living donor liver transplantation(LDLT) using the right lobe graft has widely been used to compensate for cadaveric organ shortage. To provide adequate functional volume in LDLT using the right lobe, a successful reconstruction of middle hepatic vein(MHV) is required. We describe herein a new technique using cryo-preserved aortic patch for outflow reconstruction of right lobe graft with or without MHV. MATERIALS AND METHODS: From November 2005 through March 2006, 20 adult patients who received right lobe graft(n=10) or extended right lobe graft(n=10) for LDLT were included. During the bench procedure of the right lobe graft, we reconstructed the new MHV using cryopreserved veins just like the MHV of the extended right lobe graft, and then made a venous pouch to form a common trunk between MHV (or new MHV) and RHV of the right lobe graft using a cryopreserved aortic patch. During graft implantation, anastomosis of an outflow tract was made between the venous pouch of the graft and the common trunk of recipient’s RHV-MHV-LHV. One week following the transplantation, measurement of the pressure gradient between MHV and IVC was done, as well as a regular follow-up 3D-CT scan and liver function tests. RESULTS: The mean pressure gradient between the reconstructed MHV and the recipient’s IVC was 2.3±1.2mmHg, and in all cases, serial liver function tests showed gradual improvement as the days progressed post-operatively. There were no evidences of hepatic venous congestion of the graft and/or obstruction of the reconstructed MHVs according to serial postoperative follow-up images of Doppler US and MD-CT CONCLUSION: We suggest that reconstructing the outflow tract with a cryopreserved aortic patch is a good alternative technique in preventing anterior segment congestion in LDLT using a right lobe graft with or without MHV.

Author dc:creator

• 백, 옥주

Contributors dc:contributor

• 왕, 희정
• 대학원 의학과
• 105199

• 간이식
• 중간정맥 재건술
• 냉동 보관된 혈관

Language dc:language

ko

Identifier

http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000002752
000000002752

OAI identifier oai:identifier

oai:repository.ajou.ac.kr:201003/1689