title: The use of recipient superficial femoral vein as a venous graft for portal vein reconstruction in right lobe living donor liver transplantation.
abstract: In living donor liver transplantation (LDLT), portal vein thrombosis (PVT) in the recipient is frequently regarded as a contraindication. To reconstruct the PV of a right-lobe liver graft (RLG) using an interposition or jump graft from the splenomesenteric junction, various vein grafts and technical modifications have been introduced. The internal jugular, external iliac, or great saphenous veins have been utilized in such reconstructive procedures. However, the superficial femoral vein (SFV) is preferable to the autologous vein grafts in terms of caliber, wall thickness, and length. We employed the recipient SFV to reconstruct PVT among 40 adult LDLT using RLG. Thirty-three were reconstructed by single end-to-end anastomosis with the right or left recipient PV. Three patients were transplanted with a RLG using 2 separated PVs reconstructed by double anastomoses with both the right and left PVs of the recipient. The remaining 4 patients required venous grafting for portal reconstruction. We used the recipient SFV as an interposition or jump graft from the splenomesenteric junction to the graft PV. There were 2 cases of anastomotic PV stenosis; 1 in portal reconstruction without a venous graft and the other with a SFV graft. Both were treated successfully by balloon angioplasty. The recipient SFV is an excellent size match for the PV reconstruction as a long interposition or jump conduit when the venous system from the deceased donor is not available. The indication for LDLT in patients with complete PVT should be carefully decided before transplantation in terms of portal reconstruction.
authors.affiliation: Department of Advanced Surgical and Technology, Tohoku University School of Medicine, Sendai, Aobaku, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Sato
authors.forename: S
authors.initials: S
authors.lastname: Sekiguchi
authors.forename: T
authors.initials: T
authors.lastname: Watanabe
authors.forename: Y
authors.initials: Y
authors.lastname: Enomoto
authors.forename: Y
authors.initials: Y
authors.lastname: Akamastu
authors.forename: N
authors.initials: N
authors.lastname: Kawagishi
authors.forename: S
authors.initials: S
authors.lastname: Miyagi
authors.forename: I
authors.initials: I
authors.lastname: Takeda
authors.forename: A
authors.initials: A
authors.lastname: Sato
authors.forename: K
authors.initials: K
authors.lastname: Fujimori
authors.forename: S
authors.initials: S
authors.lastname: Satomi
mesh_terms: D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical; D005268:Femoral Vein / Q000601:surgery*; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D008107:Liver Diseases / Q000145:classification / Q000601:surgery; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008875:Middle Aged; D011169:Portal Vein / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods; D012086:Reoperation; D012189:Retrospective Studies; D014182:Transplantation, Autologous; D055815:Young Adult