Ann Liver Transplant.  2022 May;2(1):102-106. 10.52604/alt.22.0013.

A critical complication of the interposition grafts using a cryopreserved aortic allograft for middle hepatic vein reconstruction in living donor liver transplantation

• Han SJ
• Kim SH
• Chon GS
• Song IS

• KMID: 2560888
• DOI: http://doi.org/10.52604/alt.22.0013

Abstract

Cryopreserved iliac vein allografts are suitable for middle hepatic vein reconstruction during living-donor liver transplantation, but their supply is often limited. Cryopreserved aorta allografts (CAG) are now one of the reliable resources, and those patency rates are comparable with polytetrafluoroethylene (PTFE) grafts. However, PTFE grafts have drawbacks of accidental gastric penetration and non-degradable foreign body. A similar complication can occur because the CAG has a similar property to PTFE, like elastic force against the pressure around organs. In this case, the patient was admitted to the ICU in hypovolemic shock due to internal bleeding. The fistula formation of the duodenum with the CAG was the reason. The patient recovered without complications after the operation, gastrojejunostomy, and feeding jejunostomy, but we did not excise the CAG. After fistulectomy, both CAG and the duodenum openings were closed with 5-0 prolene. Our experience with this case suggests that the CAG can cause problems to the adjacent organ because of its hard nature.

Keyword

Aorta; Allografts; Living donors; Liver transplantation; Fistula