Retransplantation of the liver after side-to-side caval anastomosis
Tóm tắt
Caval reconstruction in orthotopic liver transplantation is generally performed by two end-to-end anastomoses, using a portal and caval-axillary bypass to sustain hemodynamic stability. In the “piggyback” modification, the donor's suprahepatic inferior vena cava (IVC) is anastomosed end-to-side to the recipient's preserved IVC. We have used a recently described variant of the piggyback in 18 patients in whom both IVCs are anastomosed side-to-side. We report two patients who needed three retransplants after this reconstruction and conclude that regrafting can be performed in a quick and safe manner.
Tài liệu tham khảo
Belghiti J, Panis Y, Sauvanet A, Gayet B, Fékété F (1992) A new technique of side to side caval anastomosis during orthotopic hepatic transplantation without inferior vena cava occlusion. Surg Gynecol Obstet 175: 271–272
Bismuth H, Castaing D, Sherlock DJ (1992) Liver transplantation by “face-à-face” vena cava plasty. Surgery 111: 151–155
Eleborg L, Sallander S, Tollemar J (1991) Minimal hemolytic effect of venovenous bypass during liver transplantation. Transpl Int 4: 157–160
Griffith BP, Shaw BW, Hardesty RL, Iwatsuki S, Bahnson HT, Starzl TE (1985) Veno-venous bypass without systemic anticoagulation for transplantation of the human liver. Surg Gynecol Obstet 160: 270–272
Tzakis A, Todo S, Starzl TE (1989) Orthotopic liver transplantation with preservation of the inferior vena cava. Ann Surg 210: 649–652