Explant portal vein for reconstructing middle hepatic vein in right lobe living donor liver transplantation-outcome analysis

HPB (Oxford). 2018 Dec;20(12):1137-1144. doi: 10.1016/j.hpb.2018.05.008. Epub 2018 Jun 27.

Abstract

Background: The aim of the study was to study the four week patency rates of the reconstructed neo middle hepatic vein specifically using the explant portal vein (PV) in right hemiliver live donor liver transplantation (LDLT). We hypothesized that short term patency of the neo-MHV should result in good graft and patient outcomes.

Methods: Pre, intra and post operative variables were prospectively collected for 88 consecutive patients undergoing right hemiliver LDLT from January 2014 to October 2015.

Results: Explant PV was used to reconstruct neo-MHV in 76 (86.4%, 76/88) patients. Neo MHV patency rate at 28 days with explant PV was 89.4% (59/66) and with other conduit (PTFE) was 90.9% (10/11). All occlusions were detected after 7 days. There was no impact of the patency of the neo-MHV on the incidence of early allograft dysfunction, sepsis, rejection, morbidity or mortality, despite the contribution of the anterior sector to the graft volume being more than 50% in close to two-thirds of patients.

Conclusion: The reconstructed neo-MHV has excellent short term patency rates at 4 weeks. Perhaps due to the absence of early occlusions, there was no impact on graft or patient outcomes in the study population.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Feasibility Studies
  • Female
  • Graft Survival
  • Hepatic Veins / diagnostic imaging
  • Hepatic Veins / physiopathology
  • Hepatic Veins / surgery*
  • Humans
  • Liver Transplantation / adverse effects
  • Liver Transplantation / methods*
  • Living Donors*
  • Male
  • Middle Aged
  • Portal Vein / diagnostic imaging
  • Portal Vein / physiopathology
  • Portal Vein / surgery*
  • Postoperative Complications / etiology
  • Prospective Studies
  • Time Factors
  • Treatment Outcome
  • Vascular Patency*
  • Vascular Surgical Procedures* / adverse effects
  • Young Adult