Application of cryopreserved vein grafts as a conduit between the coronary vein and liver graft to reconstruct portal flow in adult living liver transplantation.
Adult-to-adult living donor liver transplantation is an alternative to donation from a deceased individual, and can help relieve the shortage of liver donations available for adult patients in Asian countries. When transplant candidates have thrombosis and deterioration of the portal vein, living donor liver transplantation is relatively contraindicated because portal veins in the grafts are short and vein grafts may not be available to reconstruct the portal vein. From June 2003 to May 2007, 82 adult living donor liver transplantations were performed at Chang-Gung Memorial Hospital. Three patients had portal vein thrombosis and marked fibrosis of the portal vein and cryopreserved vein grafts were used to reconstruct portal flow from the engorged coronary vein to the graft portal vein. All vein grafts are patent and all patients have normal liver function at 21-36 months after transplantation. When cryopreserved vein grafts are available, adult living donor liver transplantation can be successfully performed in patients with marked deterioration of the portal vein. The short distance from the engorged coronary vein to the graft portal vein may decrease the incidence of re-thrombosis of the venous conduit.
Wu
Tsung-Han
TH
Department of Liver and Transplantation Surgery, Chang-Gung Transplantation Institute, Chang-Gung Memorial Hospital, Chang-Gung University Medical School, Taoyuan, Taiwan.
Chou
Hong-Shiue
HS
Pan
Kuang-Tse
KT
Lee
Ching-Song
CS
Wu
Ting-Jun
TJ
Chu
Sung-Yu
SY
Chen
Miin-Fu
MF
Lee
Wei-Chen
WC
D000328:Adult; D001807:Blood Vessel Prosthesis; D003331:Coronary Vessels / Q000601:surgery*; D015925:Cryopreservation; D006801:Humans; D007084:Iliac Vein / Q000637:transplantation*; D008099:Liver / Q000098:blood supply*; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000601:surgery*; D020246:Venous Thrombosis / Q000601:surgery*