Korean J Transplant.  2022 Nov;36(Supple 1):S34. 10.4285/ATW2022.F-1322.

A 10-year retrospective study from a single center of the long-term patency of all-in-one sleeve patch graft venoplasty in 16 patients who underwent living donor liver transplantation with a right liver graft

• Hwang S
• Nah BG
• Jung N
• Ahn CS
• Moon DB
• Ha TY
• Song GW
• Park GC
• Lee SG

• KMID: 2535206
• DOI: http://doi.org/10.4285/ATW2022.F-1322

Abstract

Background
This retrospective study from single center aimed to evaluate the long-term patency of all-in-one sleeve venoplasty (ASV) in 16 patients who underwent living donor liver transplantation (LDLT) with a right liver graft (RLG) between 2009 and 2019. ASV unifies the right hepatic vein (RHV), short hepatic vein (SHV), and middle hepatic vein (MHV) of an RLG. ASV enables wide side-to-side anastomosis to the recipient inferior vena cava (IVC).
Methods
Of 2,875 patients who underwent LDLT with an RLG from August 2009 to July 2019, 16 (0.5%) patients underwent ASV. The ASV techniques applied to these patients, as well as patient long-term outcomes, were analyzed.
Results
Type 1 ASV unified one RHV, one IRHV, and one MHV conduit (n=12 [75.0%]). Type 2 ASV unified one RHV, multiple IRHVs, and one MHV conduit (n=4 [25.0%]). All patients are currently alive with a mean follow-up period of 70.1±41.9 months. No patient underwent retransplantation. Follow-up computed tomography showed SHV occlusion in one (6.3%) patient at 4 months, resulting in 1-, 3-, and 5-year SHV patency rates of 93.8% each. MHV occlusion was identified in six (37.5%) patients, with the 1-, 3-, and 5-year MHV patency rates being 81.3%, 68.8%, and 68.8%, respectively (P=0.037). No patient underwent endovascular stenting of the SHV or MHV. Patency rates were significantly higher for SHV than MHV (P=0.037).
Conclusions
ASV using various vascular patches is a useful technique enabling secure reconstruction of an RLG in grafts with complex hepatic vein anatomy or recipients with poor IVC condition.