Soejima Y, Yoshizumi T, Ikegami T, Harimoto N, Harada N, Ito S, Motomura T, Uchiyama H, Maehara Y
Department of Surgery and Science, Kyushu University, Fukuoka, Japan.
Department of Surgery and Science, Kyushu University, Fukuoka, Japan.
Transplant Proc. 2017 Jan-Feb;49(1):172-174. doi: 10.1016/j.transproceed.2016.10.028.
Reconstruction of multiple venous orifices of a right lobe graft is a time-consuming and troublesome procedure in right lobe living-donor liver transplantation. In the current study, we present a new venous reconstruction technique for a right lobe graft with multiple and complex hepatic vein (HV) orifices, in which procurement of the recipient's left portal vein was performed in situ to keep the anhepatic period to a minimum. All of the HV orifices were reconstructed together at the back table, while maintaining patency of the recipient's systemic and splanchnic circulation. A homologous vein graft and veno-venous bypass were not necessary. All HVs were patent during the follow-up and the patient was free from complications. In conclusion, the present technique is readily available for reconstruction of complex and multiple HV tributaries, while avoiding a long anhepatic time and the use of veno-venous bypass.
在右半肝活体供肝移植中，重建右半肝移植物的多个静脉开口是一项耗时且麻烦的操作。在本研究中，我们提出了一种针对具有多个复杂肝静脉（HV）开口的右半肝移植物的新静脉重建技术，其中在原位获取受者的左门静脉，以使无肝期最短。所有的肝静脉开口在后台一起重建，同时保持受者体循环和内脏循环的通畅。无需同种异体静脉移植物和静脉-静脉转流。随访期间所有肝静脉均保持通畅，患者无并发症发生。总之，本技术可方便地用于重建复杂和多个肝静脉分支，同时避免长时间的无肝期和使用静脉-静脉转流。
