Parietal peritoneum as a novel substitute for middle hepatic vein reconstruction during living-donor liver transplantation
Suk Kyun Hong1, Nam-Joon Yi1, Jae-Hyung Cho1, Jeong-Moo Lee1, Kwangpyo Hong1, Eui Soo Han1, Kwang-Woong Lee1, Kyung-Suk Suh1.
1Surgery, Seoul National University College of Medicine, Seoul, Korea
Background: Although autologous, cryopreserved, or artificial vascular grafts can be used as interpositional vascular substitutes for MHV reconstruction during LDLT, they are not always available, are limited in size and length, and are associated with risks of infection. This study aimed to evaluate parietal peritoneum as a novel substitute for middle hepatic vein (MHV) reconstruction during living donor liver transplantation (LDLT).
Methods: Prospectively collected data of 15 patients who underwent LDLT using the right liver with reconstruction of MHV using the patients’ own parietal peritoneum graft were retrospectively reviewed.
Results: The 1-,2-, 3-, and 5-month patency rates were 57.1%, 57.1%, 57.1%, and 28.6%, respectively. Among the total 15 cases assessed, the most recent 6 cases showed patent graft flow until discharge with 1-,2-,3-, and 5-month patency rates of 80.0%, 80.0%, 80.0%, and 20.0%, respectively. All patients survived with tolerable liver function tests. There were no significant congestion-related problems, except for one patient who experienced MHV thrombosis requiring aspiration thrombectomy and stent insertion. There were no infection-related complications. All patients survived to the final follow-up, with a minimum follow-up duration of 8 months.
Conclusions: Parietal peritoneum may be a novel autologous substitute for MHV reconstruction during LDLT.
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