Feasibility and Outcomes of Direct Dual Portal Vein Anastomosis in Living Donor Liver Transplantation Using the Right Liver Graft With Anatomic Portal Vein Variations

N. Kuriyama, A. Tanemura, A. Hayasaki, T. Fujii, Y. Iizawa, H. Kato, Y. Murata, Y. Azumi, M. Kishiwada, S. Mizuno, M. Usui, H. Sakurai, S. Isaji

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Background: Portal vein (PV) reconstruction is a crucial factor in successful living donor liver transplantation (LDLT). In LDLT using the right liver grafts with anatomic PV variations, we sometimes encounter dual PV anastomosis. In this study we describe PV variations of donor liver in detail as well as our experiences with PV reconstruction in right liver grafts with PV variations. Methods: We performed LDLT in 149 recipients between 2002 and 2016. PV variations of donor liver were classified into 3 major anatomic patterns, and we retrospectively analyzed the procedure and postoperative complications of PV anastomosis. Results: PV variations in donor livers were classified as type A (normal type) in 125 patients, type B (trifurcation type) in 7 (4.7%), and type C (caudal origin of the right posterior branch) in 17 (11.4%). Among 75 right liver grafts, 10 (13.3%) had anatomic PV variations. In 9 of 10 recipients, dual PV of the graft were anastomosed to dual PV branches of the recipient in direct end-to-end fashion. In the remaining recipient, the posterior portal branch of the graft was anastomosed to the recipient portal trunk through the interposed venous graft in end-to-end fashion and the anterior portal branch of the graft was anastomosed to the side wall of the interposed venous graft. These 10 recipients did not develop any postoperative complications associated with PV anastomosis, although 3 of the 149 recipients (2.0%) developed complications associated with PV anastomosis, such as thrombosis and necrosis. Conclusion: Dual PV anastomosis of the right liver graft is safe and feasible in LDLT, even in anatomic PV variations.

Original languageEnglish
Pages (from-to)2640-2644
Number of pages5
JournalTransplantation Proceedings
Volume50
Issue number9
DOIs
Publication statusPublished - 11-2018
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Transplantation

Fingerprint

Dive into the research topics of 'Feasibility and Outcomes of Direct Dual Portal Vein Anastomosis in Living Donor Liver Transplantation Using the Right Liver Graft With Anatomic Portal Vein Variations'. Together they form a unique fingerprint.

Cite this