title: Technique and outcome of autologous portal Y-graft interposition for anomalous right portal veins in living donor liver transplantation.
abstract: This study was intended to describe in detail the surgical technique and long-term outcome of autologous portal vein (PV) Y-graft interposition for adult living donor liver transplantation (LDLT). We assessed the outcome of 841 patients who underwent right lobe LDLT from January 2002 to December 2007 with respect to the reconstruction of double-graft PVs. PV anatomy of the donor livers was classified as type I in 796 patients (94.6%), type II in 15 patients (1.8%), and type III in 30 patients (3.6%). Seven type II grafts and all type III PV grafts had double PV orifices. Autologous PV Y-graft interposition was used in 31 patients, and complications occurred in only 1 patient during a median follow-up of 27 months. Overall, the 1- and 3-year graft survival rates were 87.5% and 80.6%, respectively. Use of a Y-graft was not a risk factor for biliary complications, but the liver anatomy of anomalous PV per se seems to be associated with a higher occurrence of biliary complications, especially during the early posttransplant period. The favorable outcome and technical feasibility of autologous portal Y-graft interposition imply that this technique could be the standard procedure for reconstruction of right lobe grafts with double PV orifices.
authors.affiliation: Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Shin
authors.initials: S
authors.lastname: Hwang
authors.forename: Sung-Gyu
authors.initials: SG
authors.lastname: Lee
authors.forename: Chul-Soo
authors.initials: CS
authors.lastname: Ahn
authors.forename: Ki-Hun
authors.initials: KH
authors.lastname: Kim
authors.forename: Deok-Bog
authors.initials: DB
authors.lastname: Moon
authors.forename: Tae-Yong
authors.initials: TY
authors.lastname: Ha
authors.forename: Gi-Won
authors.initials: GW
authors.lastname: Song
authors.forename: Dong-Hwan
authors.initials: DH
authors.lastname: Jung
authors.forename: Je-Ho
authors.initials: JH
authors.lastname: Ryu
authors.forename: Kyung-Hoon
authors.initials: KH
authors.lastname: Ko
authors.forename: Nam-Kyu
authors.initials: NK
authors.lastname: Choi
authors.forename: Kwan-Woo
authors.initials: KW
authors.lastname: Kim