Management of extensive retrohepatic vena cava defect in recipients of living donor liver transplantation.
Certain complexities, such as extensive vena caval injury, unexpected dense adhesions between liver and retrohepatic vena cava, and liver tumor abutting retrohepatic vena cava, sometimes warrant resection of vena cava during living-donor liver transplantation. Because the donor graft is devoid of vena cava, reconstruction of the retrohepatic cava is required, which can be done with the use of either a cryopreserved venous graft or an artificial conduit. With only a few published reports, the experience in vena cava reconstruction with the use of expanded polytetrafluoroethylene (ePTFE) during living-donor liver transplantation remains limited. We present our experience of 4 patients who successfully underwent vena caval resection during liver transplantation for various indications, which was subsequently reconstructed with the use of ePTFE grafts. All of these patients except 1 recovered well without any undue complications, such as thrombosis or outflow inadequacies, thus proving this extensive surgical treatment to be a successful and life-saving procedure, though meticulous skills are prerequisite.
Department of Surgery, China Medical University, Taichung, Taiwan; Organ Transplantation Center, China Medical University, Taichung, Taiwan.
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SC
Hsu
Department of Surgery, China Medical University, Taichung, Taiwan; Organ Transplantation Center, China Medical University, Taichung, Taiwan; China Medical University Hospital, China Medical University, Taichung, Taiwan. Electronic address: otc@mail.cmuh.org.tw.
L-B
LB
Jeng
Organ Transplantation Center, China Medical University, Taichung, Taiwan.
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A
Thorat
Department of Surgery, China Medical University, Taichung, Taiwan; Organ Transplantation Center, China Medical University, Taichung, Taiwan; China Medical University Hospital, China Medical University, Taichung, Taiwan.
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PC
Li
Department of Anesthesiology, China Medical University, Taichung, Taiwan.
K-S
KS
Poon
Department of Surgery, China Medical University, Taichung, Taiwan; Organ Transplantation Center, China Medical University, Taichung, Taiwan.
C-H
CH
Hsu
Department of Surgery, China Medical University, Taichung, Taiwan; Organ Transplantation Center, China Medical University, Taichung, Taiwan; China Medical University Hospital, China Medical University, Taichung, Taiwan.
C-C
CC
Yeh
Department of Surgery, China Medical University, Taichung, Taiwan; Organ Transplantation Center, China Medical University, Taichung, Taiwan.
T-H
TH
Chen
Department of Surgery, China Medical University, Taichung, Taiwan; Organ Transplantation Center, China Medical University, Taichung, Taiwan; China Medical University Hospital, China Medical University, Taichung, Taiwan.
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HR
Yang
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*