Long-term results of conjoined unification venoplasty for multiple portal vein branches of the right liver graft in living donor liver transplantations
Background : Autologous portal vein Y-graft (PYG) interposition has been the standard procedure for reconstruction of double portal vein (PV) orifices of right liver grafts during living donor liver transplantations. However, it has the disadvantage of being vulnerable to anastomotic stenosis. A ref...
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| Format: | Article |
| Language: | English |
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Korean Society for Transplantation
2019-12-01
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| Series: | Korean Journal of Transplantation |
| Subjects: | |
| Online Access: | http://journaleditor.inforang.com/journal/view.html?doi=10.4285/jkstn.2019.33.4.106 |
| _version_ | 1797370097991417856 |
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| author | Sung Yeon Yoo Shin Hwang Tae-Yong Ha Gi-Won Song Dong-Hwan Jung Gil-Chun Park Chul-Soo Ahn Deok-Bog Moon Ki-Hun Kim Young-In Yoon Yo-Han Park Hui-Dong Cho Yong-Kyu Chung Sang-Hyun Kang Jin-Uk Choi Sung-Gyu Lee |
| author_facet | Sung Yeon Yoo Shin Hwang Tae-Yong Ha Gi-Won Song Dong-Hwan Jung Gil-Chun Park Chul-Soo Ahn Deok-Bog Moon Ki-Hun Kim Young-In Yoon Yo-Han Park Hui-Dong Cho Yong-Kyu Chung Sang-Hyun Kang Jin-Uk Choi Sung-Gyu Lee |
| author_sort | Sung Yeon Yoo |
| collection | DOAJ |
| description | Background : Autologous portal vein Y-graft (PYG) interposition has been the standard procedure for reconstruction of double portal vein (PV) orifices of right liver grafts during living donor liver transplantations. However, it has the disadvantage of being vulnerable to anastomotic stenosis. A refined technique of conjoined unification venoplasty (CUV) was developed to secure PV reconstruction. Methods : We reviewed the surgical outcomes in PV reconstructions using CUVs in 21 cases which were followed up for >3 years. Results : The mean age of recipients was 51.7±4.9 years. The model for end-stage liver disease score was 15.3±6.4. The graft-recipient weight ratio was 1.12±0.21. Recipient PYGs were harvested in all cases. All living donors were blood relatives or relatives through marriage with type III PV anomalies. The number of right liver graft PV orifices was two in 19 cases and three in two cases. For the central intervening vein patch, a PV segment was used in six cases, and an autologous greater saphenous vein patch was used in the remaining 15 cases. The 21 patient cohort displayed a 100% 4-year patient survival rate. None of them underwent any PV interventions including interventional stenting. Serial follow-up computed tomography scans revealed that the reconstructed PV showed early reshaping with a stable streamlined configuration for over 3 years.Conclusion : s: PV reconstruction using the CUV technique appears to be significantly more effective in preventing PV complications. We believe that CUV is a useful technique to reconstruct right liver grafts with multiple PV orifices. |
| first_indexed | 2024-03-08T17:56:33Z |
| format | Article |
| id | doaj.art-b6f75eecf1464d74a1d96501257a633f |
| institution | Directory Open Access Journal |
| issn | 2671-8790 |
| language | English |
| last_indexed | 2024-03-08T17:56:33Z |
| publishDate | 2019-12-01 |
| publisher | Korean Society for Transplantation |
| record_format | Article |
| series | Korean Journal of Transplantation |
| spelling | doaj.art-b6f75eecf1464d74a1d96501257a633f2024-01-02T04:34:13ZengKorean Society for TransplantationKorean Journal of Transplantation2671-87902019-12-0133410611110.4285/jkstn.2019.33.4.106jkstn.2019.33.4.106Long-term results of conjoined unification venoplasty for multiple portal vein branches of the right liver graft in living donor liver transplantationsSung Yeon Yoo0Shin Hwang1Tae-Yong Ha2Gi-Won Song3Dong-Hwan Jung4Gil-Chun Park5Chul-Soo Ahn6Deok-Bog Moon7Ki-Hun Kim8Young-In Yoon9Yo-Han Park10Hui-Dong Cho11Yong-Kyu Chung12Sang-Hyun Kang13Jin-Uk Choi14Sung-Gyu Lee15Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Surgery, Busan Paik Hospital, Inje University College of Medicine, Busan, KoreaDepartment of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaBackground : Autologous portal vein Y-graft (PYG) interposition has been the standard procedure for reconstruction of double portal vein (PV) orifices of right liver grafts during living donor liver transplantations. However, it has the disadvantage of being vulnerable to anastomotic stenosis. A refined technique of conjoined unification venoplasty (CUV) was developed to secure PV reconstruction. Methods : We reviewed the surgical outcomes in PV reconstructions using CUVs in 21 cases which were followed up for >3 years. Results : The mean age of recipients was 51.7±4.9 years. The model for end-stage liver disease score was 15.3±6.4. The graft-recipient weight ratio was 1.12±0.21. Recipient PYGs were harvested in all cases. All living donors were blood relatives or relatives through marriage with type III PV anomalies. The number of right liver graft PV orifices was two in 19 cases and three in two cases. For the central intervening vein patch, a PV segment was used in six cases, and an autologous greater saphenous vein patch was used in the remaining 15 cases. The 21 patient cohort displayed a 100% 4-year patient survival rate. None of them underwent any PV interventions including interventional stenting. Serial follow-up computed tomography scans revealed that the reconstructed PV showed early reshaping with a stable streamlined configuration for over 3 years.Conclusion : s: PV reconstruction using the CUV technique appears to be significantly more effective in preventing PV complications. We believe that CUV is a useful technique to reconstruct right liver grafts with multiple PV orifices.http://journaleditor.inforang.com/journal/view.html?doi=10.4285/jkstn.2019.33.4.106living donor liver transplantation; y-graft; portal vein anomaly; anastomotic stenosis |
| spellingShingle | Sung Yeon Yoo Shin Hwang Tae-Yong Ha Gi-Won Song Dong-Hwan Jung Gil-Chun Park Chul-Soo Ahn Deok-Bog Moon Ki-Hun Kim Young-In Yoon Yo-Han Park Hui-Dong Cho Yong-Kyu Chung Sang-Hyun Kang Jin-Uk Choi Sung-Gyu Lee Long-term results of conjoined unification venoplasty for multiple portal vein branches of the right liver graft in living donor liver transplantations Korean Journal of Transplantation living donor liver transplantation; y-graft; portal vein anomaly; anastomotic stenosis |
| title | Long-term results of conjoined unification venoplasty for multiple portal vein branches of the right liver graft in living donor liver transplantations |
| title_full | Long-term results of conjoined unification venoplasty for multiple portal vein branches of the right liver graft in living donor liver transplantations |
| title_fullStr | Long-term results of conjoined unification venoplasty for multiple portal vein branches of the right liver graft in living donor liver transplantations |
| title_full_unstemmed | Long-term results of conjoined unification venoplasty for multiple portal vein branches of the right liver graft in living donor liver transplantations |
| title_short | Long-term results of conjoined unification venoplasty for multiple portal vein branches of the right liver graft in living donor liver transplantations |
| title_sort | long term results of conjoined unification venoplasty for multiple portal vein branches of the right liver graft in living donor liver transplantations |
| topic | living donor liver transplantation; y-graft; portal vein anomaly; anastomotic stenosis |
| url | http://journaleditor.inforang.com/journal/view.html?doi=10.4285/jkstn.2019.33.4.106 |
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