|
|||||
|
|
Better innovate than compromise: A novel hepatic outflow reconstruction technique in pediatric living donor liver transplantation |
|
| Authors: | P. Thomas Cherian Ashish K. Mishra Ashish Bangaari Venugopal Kota Mohan Sathyanarayanan Ravichandra Raya Mohamed Rela |
| Affiliation: | 1. Department of HPB and Liver Transplantation, Global Hospitals, Hyderabad, Telangana, India;2. Institute of Liver Disease & Transplantation, Global Health City, Chennai, Tamil Nadu, India;3. Department of Surgical Gastro and Liver Transplant, Global Hospitals, Hyderabad, Telangana, India;4. Department of Liver Transplant Anaesthesia, MIOT Hospital, Chennai, Tamil Nadu, India;5. Department of Anaesthesiology and Critical Care, Global Hospitals, Hyderabad, Telangana, India;6. Insitute of Liver Studies, King's College Hospital, London, UK |
| Abstract: | Pediatric LDLT using donors with unfavorable vascular anatomy is challenging in terms of donor safety, and complexity of reconstruction in the recipient. We describe an innovative technique of hepatic venous outflow reconstruction involving the recipient RHV, in the presence of a rudimentary RHV in the donor. The postoperative course of the donor and recipient was uneventful with satisfactory venous outflow in both. This technique avoided the use of prosthetic material, an important consideration given the recipient age and requirement for growth. This shows that donors previously considered unsuitable for donation can be utilized safely as long as principles of vascular anastomosis are adhered to. Moreover, it highlights that innovation is sometimes necessary to avoid compromise in donor safety. |
| Keywords: | live donor safety hepatic outflow obstruction innovative technique acute liver failure graft survival pediatric liver transplantation |