Cadaveric vein allografts in reconstruction of hepatic vein in adult-to-adult right lobe living donor liver transplantation

Abstract

Objective:To explore the value of cadaveric vein allografts in hepatic vein reconstruction in adult-to-adult living donor liver transplantation(LDLT).Methods:The clinical data of 9 recipients,who underwent LDLT(including the hepatic vein reconstruction)in the right liver lobe without middle hepatic vein(MHV)from June 2007 to January 2008,were retrospectively analyzed.The cadaveric vein allografts were stored in 4℃ UW solution within seven days and were used for construction of large hepatic veins such as:tributaries of the middle hepatic vein from Ⅴ,Ⅷ and right inferior hepatic vein.Results:Cadaveric interposition vein allografts were used for venous reconstruction in 9(81.8%)of 11 cases receiving a modified right liver graft,6 cases receiving one-vein reconstruction,2 cases receiving two-vein reconstruction and 1 case receiving three-vein reconstruction.Only 1 recipient died of renal failure and severe pulmonary infection on day 14 after transplantation without any hemiliver venous outflow obstruction.Doppler ultrasound showed no thrombosis and the blood flowed smoothly in the other 7 recipients during the 9 to 15 months follow-up period.The cumulative patency rates of the 8 survivals for interposition vein grafts were 72.7%(8/11),54.5%(6/11),and 36.5%(4/11)at 3,6,and 9 months,respectively.The regeneration of paramedian sectors was equivalent.Conclusion:Cadaveric vein allograft is safe,simple,and effective in adult-to-adult right lobe living donor liver transplantation for hepatic vein reconstruction.