Vilca Melendez H, Rela M, Heaton N D
Liver Transplant Surgical Service, King's College Hospital, London, UK.
Transpl Int. 1997;10(6):475-7. doi: 10.1007/s001470050090.
Reduced grafts represent an important technical development in paediatric liver transplantation. The use of a left lateral segment graft has required preservation of the native inferior vena cava to "piggy-back" the graft onto it. We report four children who underwent left lateral segment transplantation with caval replacement using the donor iliac vein because the native retrohepatic inferior vena cava was small, friable or difficult to preserve. There were no caval or hepatic vein complications post-transplant and the donor iliac vein proved to be a satisfactory interpositional graft. The technique offers the advantages of a wider retrohepatic cava avoiding venous outflow or caval obstruction, provides good tissue to suture and is well suited for the triangulation technique of the left hepatic vein.
减体积肝移植是小儿肝移植领域一项重要的技术进展。使用左外叶肝移植时，需要保留自体下腔静脉，以便将移植肝“背驮”于其上。我们报告了4例儿童接受左外叶肝移植并使用供体髂静脉进行腔静脉置换的病例，原因是自体肝后下腔静脉细小、脆弱或难以保留。移植后未出现腔静脉或肝静脉并发症，且供体髂静脉被证明是一种令人满意的置换移植物。该技术具有以下优点：肝后下腔静脉更宽，可避免静脉流出道问题或腔静脉梗阻，提供良好的缝合组织，且非常适合左肝静脉的三角吻合技术。
