Better innovate than compromise: A novel hepatic outflow reconstruction technique in pediatric living donor liver transplantation

Pediatric LDLT using donors with unfavorable vascular anatomy is challenging in terms of donor safety, and complexity of reconstruction in the recipient. We describe an innovative technique of hepatic venous outflow reconstruction involving the recipient RHV, in the presence of a rudimentary RHV in...

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Bibliographic Details
Published in:Pediatric transplantation 2015-05, Vol.19 (3), p.E56-E61
Main Authors: Cherian, P. Thomas, Mishra, Ashish K., Bangaari, Ashish, Kota, Venugopal, Sathyanarayanan, Mohan, Raya, Ravichandra, Rela, Mohamed
Format: Article
Language:English
Subjects:
acute liver failure
Algorithms
Anastomosis, Surgical
Child
graft survival
Hepatectomy - methods
hepatic outflow obstruction
Hepatic Veins - surgery
Humans
innovative technique
live donor safety
Liver - blood supply
Liver Failure
Liver Failure, Acute - surgery
Liver Transplantation - methods
Living Donors
Male
pediatric liver transplantation
Postoperative Period
Reconstructive Surgical Procedures - methods
Risk
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Summary:Pediatric LDLT using donors with unfavorable vascular anatomy is challenging in terms of donor safety, and complexity of reconstruction in the recipient. We describe an innovative technique of hepatic venous outflow reconstruction involving the recipient RHV, in the presence of a rudimentary RHV in the donor. The postoperative course of the donor and recipient was uneventful with satisfactory venous outflow in both. This technique avoided the use of prosthetic material, an important consideration given the recipient age and requirement for growth. This shows that donors previously considered unsuitable for donation can be utilized safely as long as principles of vascular anastomosis are adhered to. Moreover, it highlights that innovation is sometimes necessary to avoid compromise in donor safety.
ISSN:1397-3142
1399-3046
DOI:10.1111/petr.12437