Side-to-side portal vein reconstruction for infant-to-infant deceased donor whole liver transplantation: Report of 2 cases with video

Jung-Man Namgoong; Shin Hwang; Chul-Soo Ahn; Dong-Hwan Jung; Gil-Chun Park

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자료유형: 학술저널

저자정보: Jung-Man Namgoong (University of Ulsan College of Medicine) Shin Hwang (University of Ulsan College of Medicine) Chul-Soo Ahn (University of Ulsan College of Medicine) Dong-Hwan Jung (University of Ulsan College of Medicine) Gil-Chun Park (University of Ulsan College of Medicine)

저널정보: 한국간담췌외과학회 Annals of Hepato-Biliary-Pancreatic Surgery 한국간담췌외과학회지 제24권 제3호

발행연도: 2020.8

수록면: 301 - 304 (4page)

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Infant-to-infant whole liver transplantation (I2I-WLT) has been rarely performed in Korea. Unlike living donor liver transplantation or split liver transplantation, the donor graft portal vein (PV) in I2I-WLT is very small in diameter, so risk of PV complications increases significantly. We present two cases of I2I-WLT with application of side-to-side unification venoplasty for secure PV reconstruction. The first case recipient was a 10-month-old female baby who weighed 6.0 ㎏. She was diagnosed with progressive familial intrahepatic cholestasis. The deceased donor was a 12-month-old boy. The graft weight was 245 g, so the graft-recipient weight ratio (GRWR) was 4.1%. PV was reconstructed using side-to-side unification venoplasty. The function of graft liver recovered uneventfully and there was no evidence of PV complications. She is currently doing well for 4 years. The second case recipient was a 10-month-old female baby who weighed 8.8 ㎏. She had also undergone Kasai operation for biliary atresia. GRWR was 6.0%. Because the graft liver was much larger than the native liver, we designed the length of the extrahepatic PV more redundant than the precedent cases to avoid extrinsic compression by the large-sized caudate lobe. The PV was reconstructed using side-to-side unification venoplasty. The function of the graft liver recovered uneventfully. There was no evidence of PV complications. She is currently doing well for 2 years. As the PV size in infant donors and recipients is very small, PV reconstruction in I2I-WLT requires specialized surgical techniques of side-to-side unification venoplasty. Three supplementary video clips are provided.

#Complication #Portal vein #Pediatric transplantation #Deceased donor #Venoplasty

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