Hwang Shin, Lee Sung-Gyu, Ahn Chul-Soo, Park Kwang-Min, Kim Ki-Hun, Moon Deok-Bog, Ha Tae-Yong
Division of Hepatopancreatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Liver Transpl. 2005 Jun;11(6):644-9. doi: 10.1002/lt.20430.
Cryopreserved iliac vein grafts (IVGs) have often been used for reconstruction of middle hepatic vein (MHV) branches in right liver grafts, but their storage pool has often been exhausted in our institution due to the low incidence of deceased donor organ procurement. To overcome this shortage of IVG, we started to use cryopreserved iliac artery graft (IAG). During September and October 2004, we carried out 41 cases of adult living donor liver transplantation, including 29 right lobe grafts with MHV reconstruction. Interposition vessel grafts were autologous vein (n = 6), IVG (n = 13), and IAG (n = 10). IAG was used in 3 (21%) of 13 cases during the first month. For the next month, it was more frequently used (7 [44%] of 16) because handling of cryopreserved IAG was not difficult and its outcome was favorable. On follow-up with computed tomography for 3 months, outflow disturbance occurred in 1 (17%) of 6 autologous vein cases, in 2 (15%) of 13 IVG cases, and in 1 (10%) of 10 IAG cases. Two-month patency rate of IAG was not lower than that of IVG. In conclusion, we feel that cryopreserved IAG can be used as an interposition vessel graft for MHV reconstruction of right liver graft when cryopreserved IVG is not available.
冷冻保存的髂静脉移植物（IVG）常被用于右肝移植物中肝静脉（MHV）分支的重建，但由于脑死亡供体器官获取率较低，在我们机构其库存常常耗尽。为克服IVG的这种短缺，我们开始使用冷冻保存的髂动脉移植物（IAG）。在2004年9月和10月期间，我们进行了41例成人活体肝移植，其中包括29例进行了MHV重建的右叶移植。置入血管移植物为自体静脉（n = 6）、IVG（n = 13）和IAG（n = 10）。在第一个月，13例中有3例（21%）使用了IAG。在接下来的一个月，其使用更为频繁（16例中有7例[44%]），因为冷冻保存的IAG操作并不困难且效果良好。在术后3个月的计算机断层扫描随访中，6例自体静脉病例中有1例（17%）出现流出道梗阻，13例IVG病例中有2例（15%）出现，10例IAG病例中有1例（10%）出现。IAG的2个月通畅率不低于IVG。总之，我们认为当无法获得冷冻保存的IVG时，冷冻保存的IAG可作为右肝移植物MHV重建的置入血管移植物。
