title: Survey of adult liver transplantation techniques (SALT): an international study of current practices in deceased donor liver transplantation.
abstract: BACKGROUND
  There has been little focus lately on operative techniques for full graft liver transplantation, and the standard technique is unclear.
  
  
  METHODS
  An internet survey addressing the key technical issues was e-mailed to programme directors.
  
  
  RESULTS
  Responses were obtained from 93 out of 128 (73%) directors contacted. Programmes performed a median of 60 (8-240) transplants per year. Maximum mean cold time of 13 ± 3 h and maximum median steatosis of 40% (15-90%) were tolerated. The inferior vena cava was preserved by 48% of centres all the time and 43% selectively. European centres used temporary portacaval shunting (42%) four times more often than USA programmes. Venous bypass was always used when not preserving the inferior vena cava by less than 25%, and used selectively by approximately 40% of centres. Portal vein anastomosis with room for expansion (88%), graft hepatic artery to native gastroduodenal/common hepatic artery bifurcation (57%) and bile duct-to-duct (47%) were the favoured techniques.
  
  
  CONCLUSIONS
  A standard international operative technique for deceased donor liver transplantation does not exist, although there is a trend towards inferior vena cava preservation. Donor selection criteria were more homogenous across programmes. As suggested by the high response rate, there likely exists interest to investigate technical variations on an international scale.
authors.affiliation: New York Presbyterian Hospital - Weill-Cornell Medical Center, New York, NY, USA.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Kluger
authors.forename: Riccardo
authors.initials: R
authors.lastname: Memeo
authors.forename: Alexis
authors.initials: A
authors.lastname: Laurent
authors.forename: Claude
authors.initials: C
authors.lastname: Tayar
authors.forename: Daniel
authors.initials: D
authors.lastname: Cherqui
mesh_terms: D000328:Adult; D000349:Africa; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D001652:Bile Ducts / Q000601:surgery; D050377:Cold Ischemia; D046148:Donor Selection; D005060:Europe; D005234:Fatty Liver / Q000175:diagnosis; D019538:Health Care Surveys; D006499:Hepatic Artery / Q000601:surgery; D006801:Humans; D020407:Internet; D016031:Liver Transplantation / Q000379:methods* / Q000592:standards; D008875:Middle Aged; D008877:Middle East; D009520:New Zealand; D011167:Portacaval Shunt, Surgical; D011169:Portal Vein / Q000601:surgery; D010818:Practice Patterns, Physicians' / Q000592:standards; D013020:South America; D011795:Surveys and Questionnaires; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D016896:Treatment Outcome; D014481:United States; D014682:Vena Cava, Inferior / Q000601:surgery