title: The use of Dacron graft for cavo-cavostomy in orthotopic liver transplantation.
abstract: The end-to-end "interposition" technique and end-to-side "piggyback" technique are standard approaches to in situ anastomosis during orthotopic liver transplantation. We demonstrate that anastomosis of liver allograft to a Dacron vena cava graft can be a feasible solution if traditional anastomoses cannot be used. A 55-year-old man with end-stage liver failure from alcoholic cirrhosis underwent orthotopic liver transplantation; however, an intraoperative complication during recipient hepatectomy rendered the native vena cava unsalvageable. In addition, the donor vena cava was too short to bridge the caval defect for interposition. We therefore used Dacron for an in situ graft to span the gap, with subsequent anastomosis of the allograft to the prosthetic graft in piggyback fashion. The patient did well postoperatively; his only major complication was late anastomotic stenosis, which was treated successfully with balloon dilatation. Unfortunately the patient became recidivous and expired ten months posttransplant, despite indications of satisfactory allograft function.
authors.affiliation: Transplant Section, Department of Surgery, University of Kentucky, Lexington, KY 40536, USA.
authors.forename: Hoonbae
authors.initials: H
authors.lastname: Jeon
authors.forename: Patrick P
authors.initials: PP
authors.lastname: McHugh
authors.forename: Ambar
authors.initials: A
authors.lastname: Banerjee
authors.forename: Roberto
authors.initials: R
authors.lastname: Gedaly
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Johnston
authors.forename: Dinesh
authors.initials: D
authors.lastname: Ranjan
mesh_terms: D000714:Anastomosis, Surgical / Q000295:instrumentation / Q000379:methods; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007091:Image Processing, Computer-Assisted; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D011093:Polyethylene Terephthalates; D011167:Portacaval Shunt, Surgical / Q000295:instrumentation / Q000379:methods*; D018608:Ultrasonography, Doppler; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000601:surgery
chemical_list: D011093:Polyethylene Terephthalates