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Medical Science Monitor Basic Research

AmJCaseRep
MedSciTechnol

eISSN: 2329-0358

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Inferior Vena Cava and Venous Outflow Reconstruction in Living Donor Liver Transplantation in Children: A Single-Center Retrospective Study and Literature Review

Marek Szymczak, Piotr J. Kaliciński, Grzegorz Kowalewski, Mateusz Ciopiński, Małgorzata Markiewicz-Kijewska, Dorota Broniszczak, Bożenna Dembowska-Bagińska, Andrzej Kościesza, Grażyna Brzezińska-Rajszys, Waldemar Patkowski, Marek Stefanowicz

(Department of Pediatric Surgery and Organ Transplantation, The Children’s Memorial Health Institute, Warsaw, Poland)

Ann Transplant 2021; 26:e926217

DOI: 10.12659/AOT.926217


BACKGROUND: In this report, we present technical problems and solutions used in the reconstruction of the inferior vena cava and graft venous outflow during living donor liver transplantation (LDLT) in children.
MATERIAL AND METHODS: In 65 grafts out of 379 liver transplantations from living donors, reconstruction of multiple hepatic venous branches and/or IVC was necessary. In 4 cases, cryopreserved deceased donor venous grafts were used for the reconstruction of the IVC and/or HV.
RESULTS: Follow-up ranged from 2 months to 17.8 years (median 7.2 years). In 4 children, liver re-transplantation was required for a reason not related to venous outflow (biliary complications in 3 patients, graft insufficiency caused by small-for-size syndrome). Two patients died: 1 due to tumor recurrence and 1 due to multi-organ failure. Fifty-nine patients are alive with good liver function. One patient (1.5%) after deceased donor venous graft reconstruction showed symptoms of venous outflow obstruction, which was successfully treated with endovascular balloon angioplasty and stent placement. The remaining 59 transplanted patients do not show any signs of venous outflow obstruction.
CONCLUSIONS: In most cases, the reconstruction of multiple hepatic veins of living donor allografts can successfully be done with local venoplasty, while using cold-stored vein grafts may be helpful in selected cases of LDLT.

Keywords: Allografts, Liver Transplantation, Living Donors, inferior vena cava

This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
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