Peritoneal Patch for an Occluded Venous Conduit of a Right Lobe During a Living-Donor Liver Transplant.
Drainage of segments V and VIII venous tributaries usually is mandatory to avoid congestion of the anterior segment of right lobe during a living-donor liver transplant. Extension of the venous tributaries to the vena cava can be done with several vascular materials. Here, we describe using an 8 × 3 cm vascular patch from the peritoneum over the venous conduit (which had become kinked) that drained segments V and VIII veins. Peritoneal reconstruction worked well during the early postoperative period and avoided congestion of the right anterior liver segment. During the late postoperative period, the conduit became occluded as do other grafts used to extend tributaries; however, the collaterals that developed prevented congestion of the anterior liver segment. Using part of the peritoneum as a venous graft during living-donor liver transplant can be a good alternative to the other vascular grafting options. Peritoneal grafting provides temporary drainage of the liver lobe, prevents congestion of the anterior section, and saves time creating venous collaterals.
>From the Liver Transplantation Institute, Inonu University, Malatya, Turkey.
Cuneyt
C
Kayaalp
Parviz
P
Abbasov
Mehmet Zafer
MZ
Sabuncuoglu
Abdul Hamid
AH
Alam
Sezai
S
Yilmaz
D000328:Adult; D003097:Collateral Circulation; D005260:Female; D006085:Graft Survival; D006503:Hepatic Veins / Q000503:physiopathology / Q000601:surgery*; D006504:Hepatic Veno-Occlusive Disease / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D008102:Liver Circulation; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000601:surgery* / Q000821:virology; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D019520:Living Donors; D008875:Middle Aged; D010537:Peritoneum / Q000637:transplantation*; D013997:Time Factors; D016896:Treatment Outcome; D058017:Vascular Grafting / Q000379:methods*; D014654:Vascular Patency