title: Outcome of extra-anatomic vascular reconstruction in orthotopic liver transplantation.
abstract: BACKGROUND
  Portal venous and hepatic arterial reconstruction are critical to successful outcomes in orthotopic liver transplantation (OLT). With portal vein thrombosis or inadequate hepatic arterial inflow, extra-anatomic vascular reconstruction is required. However, the clinical outcomes following extra-anatomic vascular reconstruction are largely unknown.
  
  
  METHODS
  To determine the outcomes associated with extra-anatomic vascular reconstruction, we performed a retrospective review of 205 OLT recipients transplanted between 1995 and 2000.
  
  
  RESULTS
  Extra-anatomic portal venous inflow was based upon the recipient superior mesenteric vein using donor iliac vein graft in a retrogastric position (n = 12). Extra-anatomic arterial inflow was based on recipient infrarenal aorta using donor iliac artery graft through the transverse mesocolon (n = 25). OLT with routine anatomic vascular construction served as control (n = 168). Extra-anatomic vascular reconstruction was not associated with increased morbidity, mortality, operating room time, length of stay, or thrombosis.
  
  
  CONCLUSIONS
  We conclude that extra-anatomic vascular conduits are associated with excellent long-term outcomes and provide acceptable alternatives for vascular reconstruction in OLT.
authors.affiliation: Department of Surgery, Georgetown University Medical Center, Washington, DC 20007, USA.
authors.forename: C R
authors.initials: CR
authors.lastname: Cappadonna
authors.forename: L B
authors.initials: LB
authors.lastname: Johnson
authors.forename: A D
authors.initials: AD
authors.lastname: Lu
authors.forename: P C
authors.initials: PC
authors.lastname: Kuo
mesh_terms: D005260:Female; D006499:Hepatic Artery / Q000601:surgery* / Q000637:transplantation; D006801:Humans; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000601:surgery* / Q000637:transplantation; D012189:Retrospective Studies; D016896:Treatment Outcome