title: Complex vascular reconstruction using donor's vessel grafts in orthotopic liver transplantation.
abstract: The vascular abnormalities of recipients are associated with reconstructive difficulties with an increased risk of postoperative complications. We performed an orthotopic liver transplantation that required a complex vascular reconstruction using donor vascular grafts. A patient with hepatitis B virus cirrhosis received a liver from a brain-dead donor. Dynamic computed tomography revealed complete obstruction of the portal vein due to thrombosis as well as narrowing of the hepatic arteries. We employed orthotopic liver transplantation using the piggy-back technique with complex reconstruction of the portal vein and the hepatic arteries. For portal vein reconstruction, we used the donor's iliac vein as an interpositional conduit from the recipient's gastric coronary vein to graft the portal vein. The hepatic arteries of the graft were reconstructed at the back-table before anastomosis to the side of superior mesenteric artery using an interpositional conduit of the donor's external iliac artery. All postoperative studies revealed good graft function with an excellent blood flow through all vascular anastomoses during the first year postoperatively.
authors.affiliation: Department of Surgery, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Shimizu
authors.forename: T
authors.initials: T
authors.lastname: Onoe
authors.forename: K
authors.initials: K
authors.lastname: Ide
authors.forename: A
authors.initials: A
authors.lastname: Oshita
authors.forename: H
authors.initials: H
authors.lastname: Amano
authors.forename: T
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Y
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Y
authors.initials: Y
authors.lastname: Igarashi
authors.forename: H
authors.initials: H
authors.lastname: Tashiro
authors.forename: H
authors.initials: H
authors.lastname: Ohdan
mesh_terms: D000714:Anastomosis, Surgical; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D006509:Hepatitis B / Q000150:complications*; D006801:Humans; D007084:Iliac Vein / Q000601:surgery; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000601:surgery* / Q000821:virology; D016031:Liver Transplantation / Q000379:methods*; D017538:Mesenteric Artery, Superior / Q000601:surgery; D008875:Middle Aged; D010690:Phlebography / Q000379:methods; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000601:surgery*; D019651:Plastic Surgery Procedures; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D058017:Vascular Grafting; D014654:Vascular Patency; D020246:Venous Thrombosis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*