Unification Venoplasty to Cope With Recipient Portal Vein Anomaly During Living Donor Liver Transplantation

作者：Kang S H; Hwang S^*; Jung D H; Ahn C S; Moon D B; Ha T Y; Song G W; Kim K H; Park G C; Namgoong J M; Park Y H; Park H W; Jung B H; Lee S G

来源：Transplantation Proceedings, 2013, 45(8): 3000-3004.

DOI：10.1016/j.transproceed.2013.08.073

Purpose. To cope with recipient portal vein (PV) anomalies, such as early branching of the right posterior section (RPS), during living donor liver transplantation (LDLT) surgery, we performed a simulation study to standardize the surgical technique for unification portal venoplasty. %26lt;br%26gt;Methods. This study included an observational analysis of conventional methods utilizing RPS PV, simulation-based design of a new surgical technique, and clinical application of this new technique. %26lt;br%26gt;Results. In a case encountering RPS PV, a mild anastomotic PV stenosis was persistent over 6 months postsurgery, indicating the need for technical refinement. After computational simulation analysis, we found that simple suturing of the PV branch patch automatically resulted in a funnel-shaped elongation. A prospective recipient study (n = 30) indicated that usual PV reconstruction via the PV bifurcation method is feasible in the absence of unusual donor or recipient PV anomaly. Retrospective living donor PV anatomy analysis (n = 20) revealed that 20-mm-long limbs of the first-order PV branches are necessary to make a 10- to 15-mm-long funneled PV stump. This technique of unification venoplasty for an anomalous recipient PV was applied to an adult patient undergoing LDLT with a right liver graft, for which it was shown to be technically feasible and effective. %26lt;br%26gt;Conclusions. A simplified unification venoplasty technique was developed to cope with a recipient PV anomaly in adult LDLT.

• 出版日期2013-10