Abstract
Of 372 patients who underwent liver transplants between January 1985 and March 1995, 7 required variations in vascular anastomoses due to discrepancies in the size-match of the donor and recipient vessels, the presence of a thrombosed hepatic artery or portal vein, or complete absence of the portal vein. The techniques described herein enabled us to perform successful transplantation in all patients. Although rethrombosis of the portal vein developed in one patient after a third transplant, this patient remains clinically well. The use of an operating microscope and the harvesting of an extended length of donor superior mesenteric vein or vascular grafts of the donor iliac or saphenous vessels, for potentially difficult transplants, are invaluable techniques.
Similar content being viewed by others
References
Shaw BW Jr, Iwatsuki S, Starzl TE (1984) Alternative methods of arterialization of the hepatic graft. Surg Gynecol Obstet 159:490–493
Lynch SV, Strong RW, Ong TH, Pillay SP, Balderson GA (1992) Reduced-size liver transplantation in children. Transplant Rev 6:89–101
Strong RW, Ong TH, Pillay SP, Wall DR, Balderson G, Lynch SV (1988) A new method of segmental orthotopic liver transplantation in children. Surgery 104:104–107
Strong R, Lynch S, Yamanaka J, Kawamoto S, Pillay P, Ong TH (1995) Monosegmental liver transplantation 118:904–906
Moreno-Gonzalez E, Garcia Garcia I, Gomez Sanz R, Gansales-Pinto I, Loinaz Segurola C, Jimenez Romero C (1993) Liver transplantation in patients with thrombosis of the portal, splenic or superior mesenteric vein. Br J Surg 80:81–85
Nonami T, Yokoyama I, Iwatsuki S, Starzl TE (1992) The incidence of portal vein thrombosis at liver transplantation. Hepatology 16:1195–1198
Davidson BR, Gibson M, Dick R, Burrough A, Rolles K (1994) Incidence, risk factors, management and outcome of portal vein abnormalities at orthotopic liver transplantation. Transplantation 57:1174–1177
Stieber AC, Zetti G, Todo S, Tzakis AG, Fung JJ, Marino I, Casavilla A, Selby RR, Starzl TE (1990) The spectrum of portal vein thrombosis in liver transplantation. Ann Surg 213:199–206
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kawamoto, S., Pillay, S.P., Lynch, S.V. et al. Additional techniques adopted for major vascular anastomoses during orthotopic liver transplantation. Surg Today 28, 1237–1241 (1998). https://doi.org/10.1007/BF02482806
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02482806