Korean J Transplant.  2022 Nov;36(Supple 1):S269. 10.4285/ATW2022.F-4080.

Human dermis as a new substitute for middle hepatic vein during living donor liver transplantation: early results from ongoing clinical trial

• Kim SH
• Chun GS
• Song IS
• Han SJ

• KMID: 2535496
• DOI: http://doi.org/10.4285/ATW2022.F-4080

Abstract

Iliac vein allografts are suitable for middle hepatic vein (MHV) reconstruction during living donor liver transplantation, but their supply is often limited. (PTFE) grafts are easily available but have drawbacks of accidental gastric penetration and nondegradable foreign body. We used the acellular dermal matrix (ADM) to replace PTFE grafts. This study presents the technical details and patency outcomes of using ADM in MHV reconstruction. We reviewed the surgical techniques of ADM interposition and analyzed the patency rates in five patients who underwent living donor liver transplantation during the clinical trial period. The control groups received either Headshield grafts (n=52) or PTFE grafts (n=25). The surgical techniques for MHV reconstruction used to implant the ADM and iliac vein allografts are very similar because the techniques developed for the allografts were also applied to ADM. We made one opening with the right hepatic vein and reconstructed the middle hepatic vein. No patient underwent MHV stenting during the follow-up period in all groups. The 6-month patency rate was 63.7% in the Head-shield group versus 57.2 % in the PTFE group versus 80.0% in the ADM group. The overall graft and patient survival rates did not differ depending on the MHV interposition vessel materials. The ADM grafts demonstrated high patency rates that surpass other vessel grafts, and thus, we suggest that ADM can be reliably used for MHV reconstruction instead of artificial grafts.