title: Refinement of venous reconstruction using cryopreserved veins in right liver grafts.
abstract: Short and direct vein anastomosis is generally performed in living donor liver transplantation using a right liver graft. The graft will regenerate, however, and might thus compress the anastomosis. We formulated a strategy for outflow reconstruction in right liver graft. When reconstruction of multiple short hepatic veins was necessary, a cryopreserved inferior vena cava graft was anastomosed with the hepatic veins of the graft in a basin. When there were no major short hepatic veins in the graft, a rectangular-shaped vein graft was used to make a single orifice using the middle and right hepatic veins in the graft. When there were no tributaries of the middle hepatic vein to be reconstructed, a diamond-shaped vein patch was anastomosed on the anterior wall of the right hepatic vein orifice of the graft. These techniques were satisfactorily applied in 40 patients with no torsion or tension at the anastomotic site of the hepatic venous reconstruction or other complications in outflow. The present strategy seemed to be technically feasible for outflow reconstruction in a right liver graft.
authors.affiliation: Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Hongo, Tokyo, Japan. yasusuga-tky@umin.ac.jp
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Sugawara
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Makuuchi
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Akamatsu
authors.forename: Yoji
authors.initials: Y
authors.lastname: Kishi
authors.forename: Takashi
authors.initials: T
authors.lastname: Niiya
authors.forename: Junichi
authors.initials: J
authors.lastname: Kaneko
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Imamura
authors.forename: Norihiro
authors.initials: N
authors.lastname: Kokudo
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D015925:Cryopreservation; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*; D014680:Veins / Q000637:transplantation*