title: Novel rescue procedure for inferior vena cava reconstruction in living-donor liver transplantation using a vascular graft recovered 25 h after donors' circulatory death and systematic review.
abstract: Liver transplantation is a lifesaving treatment for patients suffering from end-stage liver disease. Rarely, acute congestion of the inferior vena cava (IVC) is being encountered because of tumor compression. MELD allocation does not reflect severity of this condition because of lack of organ failure. Herein, a patient is being presented undergoing urgent living-donor liver transplantation (LDLT) with IVC reconstruction for a fast-growing hepatic epithelioid hemangioendothelioma (HEH). IVC reconstruction using a venous graft recovered from a 25-h after circulatory-death prior transplantation became necessary to compensate severe venous congestion. Additionally, a systematic review of the literature searching MEDLINE/PubMed was performed. Protocol and eligibility criteria were specified in advance and registered at the PROSPERO registry (CRD42013004827). Published literature of IVC reconstruction in LDLT was selected. Two reports describing IVC reconstruction with cryopreserved IVC grafts and one IVC reconstruction using a deceased after-circulatory-death-donor IVC graft were included. Follow-up was at 12 and 13 months, respectively. Regarding the graft recovery in the setting of living-related donation, this graft remained patent during the nine-month follow-up period. This is the first report on the use of a venous graft from a circulatory-death-donor, not eligible for whole organ recovery. We demonstrate in this study the feasibility of using a size and blood-group-compatible IVC graft from a cold-stored donor, which can solve the problem of urgent IVC reconstruction in patients undergoing LDLT.
authors.affiliation: Department of Surgery, Swiss HPB and Transplant Center, University Hospital Zürich, Zürich, Switzerland.
authors.forename: Adrian F
authors.initials: AF
authors.lastname: Palma
authors.forename: Christian E
authors.initials: CE
authors.lastname: Oberkofler
authors.forename: Dimitri A
authors.initials: DA
authors.lastname: Raptis
authors.forename: Dilmurodjon
authors.initials: D
authors.lastname: Eshmuminov
authors.forename: Olivier
authors.initials: O
authors.lastname: de Rougemont
authors.forename: Aurelia
authors.initials: A
authors.lastname: Schnyder
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Dimitroulis
authors.forename: Mickael
authors.initials: M
authors.lastname: Lesurtel
authors.forename: Philipp
authors.initials: P
authors.lastname: Dutkowski
authors.forename: Pierre-Alain
authors.initials: PA
authors.lastname: Clavien
mesh_terms: D002986:Clinical Trials as Topic; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006390:Hemangioendothelioma / Q000601:surgery / Q000628:therapy; D006503:Hepatic Veins / Q000601:surgery*; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery / Q000628:therapy; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000379:methods*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*; D014682:Vena Cava, Inferior / Q000601:surgery*
keywords: deceased donor; graft; inferior vena cava reconstruction; living-donor liver transplantation; vessel graft