Simplified Unification Patch Venoplasty for Anomalous Portal Vein Branching in Living Donor Liver Transplantation With Right Lobe Graft |
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| Affiliation: | 1. Department of Transplantation and Regenerative Medicine, School of Medicine, Fujita Health University, Aichi, Japan;2. Registry of Japanese Pancreas Transplantation, Japan Society for Pancreas & Islet Transplantation, Osaka, Japan;1. Division of Cardiovascular Surgery, Cathay General Hospital, Taipei, Taiwan;2. School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan;1. Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland;2. Faculty of Medicine and Dentistry, Wroclaw Medical University & Department of Nephrology and Transplantation Medicine, Borowska 213, 50-556 Wroclaw, Poland;1. Division of Transplantation Surgery, Department of Surgery, Medical University of South Carolina, Charleston, South Carolina;2. Department of Surgery, Yale School of Medicine, New Haven, Connecticut;1. I Clinic of Cardiology, Poznań University of Medical Sciences, Poland;2. Department of Biochemistry and Molecular Biology, Poznań University of Medical Sciences, Poland;3. Clinic of Cardiac Surgery and Transplantology, Poznań University of Medical Sciences, Poland;1. Department of General and Transplantation Surgery, Medical University of Warsaw, Warsaw, Poland;2. Department of Transplantology and Nephrology, Medical University of Warsaw, Warsaw, Poland;3. Department of Immunology, Transplant Medicine and Internal Disease, Transplantation Institute, Medical University of Warsaw, Warsaw, Poland |
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| Abstract: | ![]()
Double portal vein (PV) branches during living donor liver transplantation (LDLT) with right lobe grafts have been considered challenging both in terms of donor safety and the complexity of vascular reconstruction in the recipient. Herein, we describe our experience with 24 adult LDLT recipients during which we employed unification patch venoplasty to reconstruct right lobe grafts with double PV orifices. We retrospectively reviewed the outcomes of 195 adult LDLT recipients receiving right lobe grafts, including 24 cases of adult LDLT recipients in which unification patch venoplasty was used to treat double PVs from January 2010 to June 2015. The anomalous portal vein branches of the donors were of type II in 7 cases (29.2%), type III in 15 cases (62.5%), and type IV in 2 cases (8.3%). We used propensity score matching analysis to compare the clinical outcomes of these recipients with those of 59 recipients who underwent adult LDLT using right lobe grafts with normal PVs in the same period. Intraoperative PV stenting was necessary in 2 (8.3%) of the 24 recipients undergoing unification patch venoplasty. During the follow-up period, all PVs remained patent until death or censoring. No significant difference in terms of postoperative vascular complications was evident between the 2 groups. Moreover, no major complications requiring reoperation or endoscopic and/or radiologic intervention developed in any of the 24 living donors with double PVs. In conclusion, our simplified unification patch venoplasty could be safe and feasible when used to reconstruct double PV orifices in right lobe LDLT from donors with complex PV anomalies. |
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