Is veno-venous bypass still needed during liver transplantation? A review of the literature.
Orthotopic liver transplantation has been made feasible with intra-operative femoral-to-jugular veno-venous bypass (VVB) to redirect the blood from the lower extremities and the kidneys to the heart. This reduces hemodynamic instability and metabolic disturbances. However, complications such as thromboses with pulmonary thrombembolism or post-reperfusion syndrome were observed in up to 30% of the cases. The latter, recent developments of cava-sparing surgical techniques, shorter anhepatic times plus optimized anesthetic management have made the necessity for a routine use of VVB questionable.
Hoffmann
Katrin
K
Department of General Surgery, Ruprecht-Karls-University, Heidelberg, Germany.
Weigand
Markus A
MA
Hillebrand
Norbert
N
Büchler
Markus W
MW
Schmidt
Jan
J
Schemmer
Peter
P
D006503:Hepatic Veins / Q000601:surgery*; D006801:Humans; D016031:Liver Transplantation; D011167:Portacaval Shunt, Surgical; D014682:Vena Cava, Inferior / Q000601:surgery*