[A case of successful multi-venous reconstruction using recipient's jugular vein in right lobe-living donor liver transplantation].
In right lobe-living donor liver transplantation (RT-LDLT), hepatic venous reconstruction of the graft is essential to prevent posttansplant graft congestion and have a good outcome. The patient was a 56-year-old man who had decompensated liver cirrhosis secondary hepatitis C with massive ascites, jaundice and hepatic encephalopathy. He underwent LDLT using his son's right lobe graft. Preoperative simulation by 3D-CT volumetry revealed that the right lobe graft needed multi-venous reconstruction for right inferior hepatic vein (RIHV) and middle hepatic venous tributaries. Preoperative CT scan revealed that the recipient had portal venous thrombus and stenosis, which meant that the recipient's explanted portal vein (EPV) was not suitable for the venous reconstruction of the right lobe graft. Therefore, the recipient's internal and external jugular veins (IJV and EJV) were procured for venous reconstruction. The multiple veins of the right lobe graft were reconstructed to have single co-orifice at the backtable, and the co-orifice was anastomosed to inferior vena cava in short time. The recipient discharged on postoperative day 22 with good venous patency. In RT-LDLT unavailable for recipient's EPV, recipient's IJV and EJV grafts are very useful for multi-venous reconstruction.
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
Mizue
M
Matsuo
Toru
T
Ikegami
Kazutoyo
K
Morita
Hiroko
H
Yano
Naotaka
N
Hashimoto
Hiroto
H
Kayashima
Toshirou
T
Masuda
Naoko
N
Kondou
Tomoharu
T
Yoshizumi
Akinobu
A
Taketomi
Ken
K
Shirabe
Yoshihiko
Y
Maehara
D006503:Hepatic Veins / Q000601:surgery*; D006801:Humans; D007601:Jugular Veins / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D014656:Vascular Surgical Procedures / Q000379:methods