title: Hepatic venous reconstruction using the superficial femoral vein in a right-lobe living donor liver transplant patient with interrupted inferior vena cava.
abstract: Anatomical abnormalities in patients with BA often include polysplenia, preduodenal portal vein, interrupted retrohepatic IVC, cardiac abnormalities, and situs inversus. In LDLT patients who had congenital vascular anomalies, additional surgical modifications for the reconstruction of hepatic venous branches are sometimes necessary to prevent venous parenchymal congestion. We report a 12-yr-old female with post-Kasai BA with interrupted retrohepatic IVC who underwent right-lobe LDLT because the left liver graft volume was insufficient. The donor right liver graft had three major hepatic branches, including the RHV, IRHV, and MHV tributary (V8). We performed hepatic venous reconstruction by creating a large, wide triple orifice consisting of the RHV and two SFVs, which were anastomosed to the V8 and IRHV using the donor's SFV as an interposition graft. In conclusion, the reconstruction of venous orifices for right-lobe LDLT patients with the absent retrohepatic IVC is can be carried out using an SFV graft derived from the living donor or the recipient.
authors.affiliation: Advanced Surgical Science and Technology Division, Department of Surgery, Graduate School of Medicine, University of Tohoku, Sendai, Japan.
authors.forename: Kazushige
authors.initials: K
authors.lastname: Sato
authors.forename: Satoshi
authors.initials: S
authors.lastname: Sekiguchi
authors.forename: Naoki
authors.initials: N
authors.lastname: Kawagishi
authors.forename: Yorihiro
authors.initials: Y
authors.lastname: Akamatsu
authors.forename: Shigeto
authors.initials: S
authors.lastname: Miyagi
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Yamaya
authors.forename: Ikuo
authors.initials: I
authors.lastname: Takeda
authors.forename: Daizo
authors.initials: D
authors.lastname: Fukushima
authors.forename: Akira
authors.initials: A
authors.lastname: Sato
authors.forename: Noriaki
authors.initials: N
authors.lastname: Ohuchi
authors.forename: Susumu
authors.initials: S
authors.lastname: Satomi
mesh_terms: D000714:Anastomosis, Surgical; D001656:Biliary Atresia / Q000601:surgery* / Q000628:therapy; D002648:Child; D005260:Female; D005268:Femoral Vein / Q000601:surgery*; D006503:Hepatic Veins / Q000601:surgery; D006801:Humans; D008099:Liver / Q000098:blood supply* / Q000473:pathology; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D011169:Portal Vein / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D016896:Treatment Outcome; D054079:Vascular Malformations; D014656:Vascular Surgical Procedures / Q000379:methods*; D014682:Vena Cava, Inferior / Q000601:surgery
keywords: biliary atresia; interrupted inferior vena cava; living donor liver transplantation; splenic malformation syndrome; superficial femoral vein