Additional techniques adopted for major vascular anastomoses during orthotopic liver transplantation

• Published in: Surgery today (Tokyo, Japan) Vol. 28; no. 12; pp. 1237 - 1241
• Main Authors: Kawamoto, S, Pillay, S P, Lynch, S V, Ong, T H, Wall, D R, Yamanaka, J, Strong, R W
• Format: Journal Article
• Language: English
• Published: Japan 01.01.1998
• Subjects: Adult; Anastomosis, Surgical - methods; Child, Preschool; Female; Hepatic Artery - surgery; Humans; Iliac Artery - transplantation; Liver Transplantation; Male; Mesenteric Veins - transplantation; Middle Aged; Portal Vein - surgery; Regional Blood Flow; Saphenous Vein - transplantation
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/BF02482806

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.