Ann Liver Transplant.  2022 May;2(1):56-63. 10.52604/alt.22.0010.

Clinical applicability of autologous great saphenous vein for living donor liver transplantation

• Ha TY
• Hwang S
• Ahn CS
• Moon DB
• Song GW
• Jung DH
• Park GC

• KMID: 2560882
• DOI: http://doi.org/10.52604/alt.22.0010

Abstract

The great saphenous vein (GSV) is the longest vein in the human body. Because the GSV has a small diameter, the clinical use of an autologous GSV has been limited. In the field of living donor liver transplantation (LDLT), it has been used frequently because of a shortage of vessel allograft supply. In this study, we present our experience of autologous GSV used in adult LDLT. In our initial experience of LDLT using a modified right liver graft, we used the hydraulically dilated GSV conduit as an interposition graft for middle hepatic vein reconstruction, but it was no longer used. An autologous GSV has been frequently used as a patch for right hepatic vein venoplasty and for unification of inferior right hepatic-vein orifices. A GSV segment can be attached to a figure of 8-shaped graft portal vein orifice to facilitate portal vein reconstruction. A stack of two ring-shaped GSV segments can provide additional length to the recipient portal vein after excision of the damaged proximal portal vein stump. Two separate graft portal veins can be unified by means of unification patch venoplasty using GSV patches. A new Y-shaped vein graft can be made by means of a stack of multiple ring-shaped SGV segments. It is feasible to make a paneled patch or spirally wound conduit using a GSV. A GSV was also used as an interposition conduit for hepatic artery reconstruction. In conclusion, the autologous GSV is a useful vascular material for LDLT in the forms of a vein segment itself, a paneled vein patch, and a ring-shaped or spirally winded vein conduit.

Keyword

Great saphenous vein; Patch; Interposition; Autologous vein; Wound complication