Korean J Transplant.  2022 Nov;36(Supple 1):S338. 10.4285/ATW2022.F-4833.

Feasibility of using artificial vascular grafts in one-orifice venoplasty for middle hepatic vein reconstruction during living donor liver transplantation

• Ho VL
• Le VT
• Vu VQ
• Le VL
• Le TH
• Vu NT
• Anh Nguyen HN

• KMID: 2535565
• DOI: http://doi.org/10.4285/ATW2022.F-4833

Abstract

Background
Middle hepatic vein (MHV) reconstruction is essential to optimize the outflow of the graft in adult-to-adult right lobe living donor liver transplantation (LDLT). The present study aimed to evaluate the safety and feasibility of using artificial vascular to replace MHV with single institute experiences.
Methods
Polyester prostheses were used in reconstructing the MHV when the remnant liver volume was less than 35% of the donor liver volume. Venous branches with diameter greater than 5 mm were preserved and anastomosed to the prosthesis. Sub-sequently, MHV graft was sutured to the right hepatic vein to make one-orifice hepatic vein. From April 2019 to June 2022, 58 cases of LDLT were included in this study.
Results
The average age of recipients was 51.8±10.6 years; model for end-stage liver disease score was 26.4±11.5; and graft-recipient weight ratio was 1.32±2.9. The average of back-table time was 38.6±8.7 minutes. V5 reconstruction was done in double (n=11, 24.1%), single (n=41, 70.7%), and none (n=3, 5.2%). V8 reconstruction was done in triple (n=1, 1.7%), double (n=3, 5.2%), sin-gle (n=40, 68.9%), and none (n=14, 24.2%). One-month and 6-month conduit patency rates of the vascular grafts were 94.8% and 63.1%, respectively.
Conclusions
One-orifice venoplasty with polyester prostheses for MHV reconstruction was feasible in adult-to-adult right lobe LDLT.