Results of end-to-end cavocavostomy during adult liver transplantation.
The results of end-to-end cavocavostomy during adult liver transplantation were analyzed with special regard to caval complications. In a series of 1000 liver transplants, we observed 17 patients who suffered from postoperative caval obstruction (6 patients) or caval stenosis (11 patients), for an incidence of 1.7%. Surgical therapy was performed in 10 patients (58.8%), and 5 patients required retransplantation (29.4%). Four patients died during the later postoperative course. Two fatalities were related to caval complications, resulting in a mortality rate of 11.8%. Our results indicate that end-to-end cavocavostomy is a safe technique for cavocaval anastomosis. For only a few exceptions, such as pediatric transplantation, reduced size livers, or size mismatch between donor and recipient, should alternative techniques such as end-to-side or side-to-side cavocavostomy be performed.
Glanemann
Matthias
M
Department of General, Visceral, and Transplantation Surgery, Charité, Campus Virchow Klinikum, Humboldt University of Berlin, Augustenburger Platz 1, 13353 Berlin, Germany. matthias.glanemann@charite.de
Settmacher
Utz
U
Langrehr
Jan M
JM
Stange
Barbara
B
Haase
Roland
R
Nuessler
Natascha C
NC
Lopez-Hänninen
Enrique
E
Podrabsky
Petr
P
Bechstein
Wolf-Otto
WO
Neuhaus
Peter
P
D000328:Adult; D000714:Anastomosis, Surgical / Q000009:adverse effects* / Q000401:mortality*; D003251:Constriction, Pathologic / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D005500:Follow-Up Studies; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality*; D011183:Postoperative Complications; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D014689:Venous Insufficiency / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality*