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논문 기본 정보

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학술저널
저자정보
Sung-Gyu Lee (Department of Surgery Asan Medical Center University of Ulsan College of Medicine Seoul) Shin Hwang (Asan Medical Center University of Ulsan College of Medicine Seoul) Tae Yong Ha (Asan Medical Center University of Ulsan College of Medicine) Gi Won Song (Department of Surgery Asan Medical Center University of Ulsan College of Medicine Seoul Korea) Dong-Hwan Jung (University of Ulsan College of Medicine) Gil-Chun Park (Surgery Asan Medical Center University of Ulsan College of Medicine Seoul) Chul-Soo Ahn (Ulsan University College of Medicine) Deok-Bog Moon (University of Ulsan College of Medicine) Ki Hun Kim (Department of Surgery Inje University Busan Paik Hospital Busan) Young-In Yoon (Division of Liver Transplantation and Hepatobiliary Surgery Department of Surgery Asan Medical Cen) Yo Han Park (University of Ulsan College of Medicine) Hui-Dong Cho (Department of Surgery Asan Medical Center University of Ulsan College of Medicine) Yong-Kyu Chung Sang-Hyun Kang Jin-Uk Choi Sung Gyu Lee
저널정보
대한이식학회 Clinical Transplantation and Research Korean Journal of Transplantation Vol.33 No.4
발행연도
2019.1
수록면
106 - 111 (6page)

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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. Conclusions: 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.
#Living donor liver transplantation #Y-graft #Portal vein anomaly #Anastomotic stenosis

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참고문헌 (15)

참고문헌 신청
Hwang S / 2006 / Lessons learned from 1,000 living donor liver transplantations in a single center: how to make living donations safe / Liver Transpl 12:920~927 google schola Marcos A / 2001 / Reconstruction of double hepatic arterial and portal venous branches for right-lobe living donor liver transplantation / Liver Transpl 7:673~679 google schola Thayer WP / 2002 / Portal vein reconstruction in right lobe living-donor liver transplantation / J Am Coll Surg 194:96~98 google schola Lee SG / 2003 / Approach to anatomic variations of the graft portal vein in right lobe living-donor liver transplantation / Transplantation 75(3 Suppl):S28~S32 google schola Hwang S / 2009 / Technique and outcome of autologous portal Y-graft interposition for anomalous right portal veins in living donor liver transplantation / Liver Transpl 15:427~434 google schola

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