title: Alternatives to the double vena cava method in partial liver transplantation.
abstract: Minimizing graft congestion in partial liver transplantation is important, especially when the graft weight is marginal for the recipient metabolic demand. We prefer the double vena cava technique for reconstructing middle hepatic vein tributaries with thick, short hepatic veins because the technique can reduce the warm ischemic time of the graft and make a wide anastomosis. This technique requires a cryopreserved superior or inferior vena cava. We devised an alternative double vena cava method using iliac or femoral vein grafts and applied it to two right liver transplantation patients. There was no postoperative hepatic venous outflow block in either patient. In conclusion, application of this technique, even in the absence of a suitable vena cava, can help to minimize graft congestion.
authors.affiliation: Artificial Organ and Transplantation Division, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
authors.forename: Yoji
authors.initials: Y
authors.lastname: Kishi
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Sugawara
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Matsui
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Akamatsu
authors.forename: Noboru
authors.initials: N
authors.lastname: Motomura
authors.forename: Shinichi
authors.initials: S
authors.lastname: Takamoto
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Makuuchi
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D005268:Femoral Vein / Q000637:transplantation*; D005500:Follow-Up Studies; D006085:Graft Survival; D006503:Hepatic Veins / Q000601:surgery*; D006801:Humans; D007084:Iliac Vein / Q000637:transplantation*; D016031:Liver Transplantation / Q000379:methods*; D014682:Vena Cava, Inferior / Q000601:surgery*