Hepatic venous outflow reconstruction in right live donor liver transplantation
Malago, Massimo ; Molmenti, Ernesto P ; Paul, Andreas ; Nadalin, Silvio ; Lang, Hauke ; Radtke, Arnold ; Liu, Chao ; Frilling, Andrea ; Biglarnia, Reza LU
and Broelsch, Christoph E
(2005)
In Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
11(3).
p.5-364
- Abstract
The increasing experience with live donor liver transplantation has allowed for the identification of potential morbidities associated with technical considerations. Technical graft failure can be associated with both inflow and outflow vascular compromise. Although the latter has not always been given the relevance of the former, evidence pointing to its pivotal role continues to mount. We believe that impaired venous outflow was a cause of previously unexplained graft failures during our initial experience. Based on this observation, we developed a technique to prevent the "choking" of the graft at the outflow anastomosis with the inferior vena cava (IVC). The enhanced outflow via a cloaca maximum is achieved by reconstructing the... (More)
The increasing experience with live donor liver transplantation has allowed for the identification of potential morbidities associated with technical considerations. Technical graft failure can be associated with both inflow and outflow vascular compromise. Although the latter has not always been given the relevance of the former, evidence pointing to its pivotal role continues to mount. We believe that impaired venous outflow was a cause of previously unexplained graft failures during our initial experience. Based on this observation, we developed a technique to prevent the "choking" of the graft at the outflow anastomosis with the inferior vena cava (IVC). The enhanced outflow via a cloaca maximum is achieved by reconstructing the graft vessels with preserved veins or arteries (usually iliac vessels are used) from a blood-group-identical or blood-group-compatible deceased organ donor. Alternatively, hepatic vein or portal vein obtained from the resected native liver can be used. The reconstructed common outflow is anastomosed to a triangular opening of the IVC. Such enhanced outflow provides optimal venous drainage, especially during the early phase of growth of the graft.
(Less)
- author
- Malago, Massimo
; Molmenti, Ernesto P
; Paul, Andreas
; Nadalin, Silvio
; Lang, Hauke
; Radtke, Arnold
; Liu, Chao
; Frilling, Andrea
; Biglarnia, Reza
LU
and Broelsch, Christoph E
- publishing date
- 2005-03
- type
- Contribution to journal
- publication status
- published
- keywords
- Anastomosis, Surgical, Hepatectomy/methods, Hepatic Veins/surgery, Humans, Liver Transplantation/methods, Living Donors, Plastic Surgery Procedures/methods, Tissue and Organ Harvesting/methods
- in
- Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
- volume
- 11
- issue
- 3
- pages
- 5 - 364
- publisher
- Lippincott Williams & Wilkins
- external identifiers
-
- pmid:15719402
- scopus:20144389067
- ISSN
- 1527-6465
- DOI
- 10.1002/lt.20369
- language
- English
- LU publication?
- no
- id
- e1cba7ec-5b32-4d10-a396-75771a146d0f
- date added to LUP
- 2025-12-17 14:24:58
- date last changed
- 2025-12-19 02:25:42
@article{e1cba7ec-5b32-4d10-a396-75771a146d0f,
abstract = {{<p>The increasing experience with live donor liver transplantation has allowed for the identification of potential morbidities associated with technical considerations. Technical graft failure can be associated with both inflow and outflow vascular compromise. Although the latter has not always been given the relevance of the former, evidence pointing to its pivotal role continues to mount. We believe that impaired venous outflow was a cause of previously unexplained graft failures during our initial experience. Based on this observation, we developed a technique to prevent the "choking" of the graft at the outflow anastomosis with the inferior vena cava (IVC). The enhanced outflow via a cloaca maximum is achieved by reconstructing the graft vessels with preserved veins or arteries (usually iliac vessels are used) from a blood-group-identical or blood-group-compatible deceased organ donor. Alternatively, hepatic vein or portal vein obtained from the resected native liver can be used. The reconstructed common outflow is anastomosed to a triangular opening of the IVC. Such enhanced outflow provides optimal venous drainage, especially during the early phase of growth of the graft.</p>}},
author = {{Malago, Massimo and Molmenti, Ernesto P and Paul, Andreas and Nadalin, Silvio and Lang, Hauke and Radtke, Arnold and Liu, Chao and Frilling, Andrea and Biglarnia, Reza and Broelsch, Christoph E}},
issn = {{1527-6465}},
keywords = {{Anastomosis, Surgical; Hepatectomy/methods; Hepatic Veins/surgery; Humans; Liver Transplantation/methods; Living Donors; Plastic Surgery Procedures/methods; Tissue and Organ Harvesting/methods}},
language = {{eng}},
number = {{3}},
pages = {{5--364}},
publisher = {{Lippincott Williams & Wilkins}},
series = {{Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society}},
title = {{Hepatic venous outflow reconstruction in right live donor liver transplantation}},
url = {{http://dx.doi.org/10.1002/lt.20369}},
doi = {{10.1002/lt.20369}},
volume = {{11}},
year = {{2005}},
}