title: Conventional versus piggyback techniques: do they have different outcomes?
abstract: BACKGROUND
  Conventional orthotopic liver transplant includes resection of the recipient's native liver, together with the retrohepatic inferior vena cava, whereas with the piggyback technique, the recipient's vena cava is preserved and the donor's vena cava is anastomosed with the recipient's hepatic veins. So the caval flow is maintained during explantation, but on the other hand, the cava must be dissected completely from the liver, prolonging hepatic excision.
  
  
  OBJECTIVE
  To compare outcomes of conventional versus piggyback techniques. Primary outcomes were serious adverse events or complications, and secondary outcomes were graft survival for 3 and 12 months, quality of life, days in the intensive care unit and in the hospital, and days spent receiving mechanical ventilation.
  
  
  METHODS
  From January 3, 2007, to December 31, 2008, 120 liver transplant patients were divided into 2 groups: conventional (n = 93) and piggyback (n = 27).
  
  
  RESULTS
  Intraoperative and postoperative complications, graft survival for 3 and 12 months, quality of life, and hospital stay did not differ significantly between the 2 groups. However, the stay in the intensive care unit (median, 2 vs 3 days; range, 1-101 vs 1-60 days) and the number of days on ventilatory support (median, 1 vs 2 days; range, 0-41 vs 1-60 days) were notably lower in the conventional group.
  
  
  CONCLUSIONS
  The conventional liver transplant technique had significantly better results than the piggyback technique in terms of length of stay in the intensive care unit and duration of mechanical ventilation.
authors.affiliation: Royal Free Hospital Trust and Royal Free, University College School of Medicine, London, United Kingdom.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Ghazaly
authors.affiliation: Royal Free Hospital Trust and Royal Free, University College School of Medicine, London, United Kingdom.
authors.forename: Brian R
authors.initials: BR
authors.lastname: Davidson
mesh_terms: D000203:Activities of Daily Living; D005260:Female; D006085:Graft Survival; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D011183:Postoperative Complications; D011788:Quality of Life; D012189:Retrospective Studies; D014682:Vena Cava, Inferior / Q000601:surgery