title: Better innovate than compromise: a novel hepatic outflow reconstruction technique in pediatric living donor liver transplantation.
abstract: Pediatric LDLT using donors with unfavorable vascular anatomy is challenging in terms of donor safety, and complexity of reconstruction in the recipient. We describe an innovative technique of hepatic venous outflow reconstruction involving the recipient RHV, in the presence of a rudimentary RHV in the donor. The postoperative course of the donor and recipient was uneventful with satisfactory venous outflow in both. This technique avoided the use of prosthetic material, an important consideration given the recipient age and requirement for growth. This shows that donors previously considered unsuitable for donation can be utilized safely as long as principles of vascular anastomosis are adhered to. Moreover, it highlights that innovation is sometimes necessary to avoid compromise in donor safety.
authors: Department of HPB and Liver Transplantation, Global Hospitals, Hyderabad, Telangana, India; Institute of Liver Disease & Transplantation, Global Health City, Chennai, Tamil Nadu, India.
authors: P Thomas
authors: PT
authors: Cherian
authors: Ashish K
authors: AK
authors: Mishra
authors: Ashish
authors: A
authors: Bangaari
authors: Venugopal
authors: V
authors: Kota
authors: Mohan
authors: M
authors: Sathyanarayanan
authors: Ravichandra
authors: R
authors: Raya
authors: Mohamed
authors: M
authors: Rela
mesh_terms: D000465:Algorithms; D000714:Anastomosis, Surgical; D002648:Child; D006498:Hepatectomy / Q000379:methods; D006503:Hepatic Veins / Q000601:surgery*; D006801:Humans; D008099:Liver / Q000098:blood supply*; D017093:Liver Failure; D017114:Liver Failure, Acute / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D011184:Postoperative Period; D019651:Plastic Surgery Procedures / Q000379:methods; D012306:Risk
keywords: acute liver failure; graft survival; hepatic outflow obstruction; innovative technique; live donor safety; pediatric liver transplantation