AI Article Synopsis
- Venous reconstruction in living-donor liver transplantation for Budd-Chiari syndrome (BCS) poses difficulties due to missing vena cava in donor grafts, requiring innovative surgical techniques to address thrombosis and stenosis.
- A retrospective analysis of 22 patients highlighted the creation of a wide, triangular opening for venous drainage as the primary method, with specific alternatives used for patients with completely blocked vena cava.
- The study concludes that effective venous reconstruction in BCS is possible without patch-plasty, supporting living-donor liver transplantation as a viable solution given the limited availability of deceased donors.
Article Abstract
Background: Venous reconstruction in living-donor liver transplantation for Budd-Chiari syndrome (BCS) has challenges because the grafts from living donors lack vena cava, and hepatic venous anastomosis must be performed on an already-thrombosed and/or stenosed inferior vena cava. Several techniques are described to overcome this problem, and we represent our experience with 22 patients.
Methods: Medical recordings of 22 patients were retrospectively collected, and disease-specific data as well as recordings about surgical technique were analyzed.
Results: Creation of a wide, triangular de novo orifice was the main method used for venous drainage, which was used in 19 patients. The remaining 3 patients had totally thrombosed vena cava; thus, direct anastomosis to the supra-hepatic portion of the vena cava was used in 2 patients and an anastomosis to the right atrium was used in 1 patient.
Conclusions: Venous reconstruction in BCS can be achieved without the use of patch-plasty, and the inferior vena cava can be safely resected in selected patients. Living-donor liver transplantation is a feasible option for the treatment of BCS, considering the scarcity of cavaderic donors.
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| http://dx.doi.org/10.1016/j.transproceed.2017.04.028 | DOI Listing |
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