Fast Vascular Reconstruction With Magnetic Devices in Liver Transplant: A Novel Surgical Technique.

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Minimizing the anhepatic period is critical to reduce allograft dysfunction, intestinal bacterial translocation, and acute liver failure among liver transplant (LT) recipients. The current study introduced a new surgical technique for fast major vascular reconstruction by utilization of magnetic devices in recipients. A prospective study was conducted among patients who underwent orthotopic LT using Donation after Cardiac Death (DCD) between November 2018 and December 2019. The procedures of magnetic-assisted LT was clinically performed and introduced. In brief, three pairs of C-shaped magnetic rings and matched base members were placed and fixed in the stump of supra- and infra-hepatic inferior vena cava, as well as portal vein of the donors and recipients. The donor liver was implanted, and the magnet rings at the donor and recipient vessels attached immediately for a rapid reconstruction. Final continuous suture of the vessels was then performed under restoration of the blood flow. A total of six patients were finally enrolled in magnetic-assisted LT. The median age of the recipients was 40.0 (IQR 37.0-49.3) years, and all were male patients as well. The median anhepatic time of patients undergoing magnetic-assisted LT was 10.3 min (IQR 9.5-13.2 min). With a median follow-up of 10.5 (range 7.2-19.8) months, all patients recovered well with normal liver function. Two patients had experienced partial portal vein thrombosis or acute rejection, respectively, which were unrelated to the surgical techniques, and treated successfully. The magnetic-assisted vascular anastomosis shortened the anhepatic phase to only about 10 min during LT. Fast revascularization of the donor liver by using the novel magnetic technique is safe and feasible in LT.