title: One-step venous reconstruction using the donor's round ligament in right-lobe living-donor liver transplantation.
abstract: We herein report the use of an opened round ligament as a venous patch graft for inferior right hepatic vein (IRHV) reconstruction and anastomosis to the inferior vena cava (IVC) in living-donor liver transplantation (LDLT) using a right-lobe (RL) graft. After laparotomy, the donor's round ligament was harvested and opened, and the semi-transparent umbilical vein, which was 7.0 cm in length and 3.0 cm in width, was carefully trimmed on the back table for use as a patch graft. The right hepatic vein of the graft was anastomosed to the harvested patch, and the IRHV was anastomosed to an independent hole made in the wall on the other side of the patch, to form a bridged vascular patch for anastomosis to the IVC. The interposition graft filled promptly and provided a good outflow from the posterior segment. This is the first report of venous reconstruction using a donor's round ligament graft in RL-LDLT.
authors.affiliation: Department of Surgery and Science, Graduate School of Medicine, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan, toshima@surg2.med.kyushu-u.ac.jp.
authors.forename: Takeo
authors.initials: T
authors.lastname: Toshima
authors.forename: Toru
authors.initials: T
authors.lastname: Ikegami
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Matsumoto
authors.forename: Shohei
authors.initials: S
authors.lastname: Yoshiya
authors.forename: Norifumi
authors.initials: N
authors.lastname: Harimoto
authors.forename: Yo-ichi
authors.initials: Y
authors.lastname: Yamashita
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Yoshizumi
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ikeda
authors.forename: Ken
authors.initials: K
authors.lastname: Shirabe
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D015209:Cholangitis, Sclerosing / Q000150:complications; D003093:Colitis, Ulcerative / Q000150:complications; D058625:End Stage Liver Disease / Q000209:etiology / Q000601:surgery*; D005260:Female; D006503:Hepatic Veins / Q000601:surgery*; D006801:Humans; D007813:Laparotomy; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012404:Round Ligament of Uterus / Q000637:transplantation*; D020858:Tissue and Organ Harvesting / Q000379:methods; D016896:Treatment Outcome; D014471:Umbilical Veins / Q000601:surgery / Q000637:transplantation; D014682:Vena Cava, Inferior / Q000601:surgery; D055815:Young Adult