Thrombectomized autologous portal Y-graft inflow construction can be an option in living-donor liver transplantation: a case report.

Living-donor liver transplantation Portal Y-graft interposition Portal vein thrombosis

Journal

Surgical case reports
ISSN: 2198-7793
Titre abrégé: Surg Case Rep
Pays: Germany
ID NLM: 101662125

Informations de publication

Date de publication:
10 Apr 2023
Historique:
received: 23 02 2023
accepted: 03 04 2023
medline: 10 4 2023
entrez: 9 4 2023
pubmed: 10 4 2023
Statut: epublish

Résumé

In living-donor liver transplantation (LDLT), portal Y-graft interposition using the recipient's portal vein (PV) bifurcation has been used for right lobe grafts with double PV orifices. We herein report the use of thrombectomized autologous portal Y-graft interposition for a recipient with preoperative portal vein thrombosis (PVT) in a right lobe LDLT with double PV orifices. The recipient was a 54-year-old male with end-stage liver disease due to alcoholic liver cirrhosis. There was PV thrombus in the recipient's PV. The living liver donor was his 53-year-old spouse, and a right lobe graft was planned for the transplantation. Since the donor's liver had a type III PV anomaly, autologous portal Y-graft interposition after thrombectomy was planned for PV reconstruction in the LDLT. The portal Y-graft was resected from the recipient and a thrombus extending from the main PV to the right PV branch was removed on the back table. The portal Y-graft was anastomosed to the anterior and posterior portal branches of the right lobe graft. Followed by venous reconstruction, the Y-graft was anastomosed to the recipient's main PV. The operation time was 545 min and the intraoperative blood loss was 1355 ml. The recipient was discharged on postoperative day 13 without any complications. The recipient remains well with the patency of the portal Y-graft one year after the liver transplantation. We herein report the successful use of autologous portal Y-graft interposition after thrombectomy on the back table for a recipient with PVT in a right lobe LDLT.

Sections du résumé

BACKGROUND BACKGROUND
In living-donor liver transplantation (LDLT), portal Y-graft interposition using the recipient's portal vein (PV) bifurcation has been used for right lobe grafts with double PV orifices. We herein report the use of thrombectomized autologous portal Y-graft interposition for a recipient with preoperative portal vein thrombosis (PVT) in a right lobe LDLT with double PV orifices.
CASE PRESENTATION METHODS
The recipient was a 54-year-old male with end-stage liver disease due to alcoholic liver cirrhosis. There was PV thrombus in the recipient's PV. The living liver donor was his 53-year-old spouse, and a right lobe graft was planned for the transplantation. Since the donor's liver had a type III PV anomaly, autologous portal Y-graft interposition after thrombectomy was planned for PV reconstruction in the LDLT. The portal Y-graft was resected from the recipient and a thrombus extending from the main PV to the right PV branch was removed on the back table. The portal Y-graft was anastomosed to the anterior and posterior portal branches of the right lobe graft. Followed by venous reconstruction, the Y-graft was anastomosed to the recipient's main PV. The operation time was 545 min and the intraoperative blood loss was 1355 ml. The recipient was discharged on postoperative day 13 without any complications. The recipient remains well with the patency of the portal Y-graft one year after the liver transplantation.
CONCLUSION CONCLUSIONS
We herein report the successful use of autologous portal Y-graft interposition after thrombectomy on the back table for a recipient with PVT in a right lobe LDLT.

Identifiants

DOI: 10.1186/s40792-023-01641-8 PMID: 37032409 PMC: PMC10083146
pubmed: 37032409
doi: 10.1186/s40792-023-01641-8
pii: 10.1186/s40792-023-01641-8
pmc: PMC10083146
doi:

Types de publication

Journal Article

Langues

eng

Pagination

57

Subventions

Organisme : Japan Society for the Promotion of Science
ID : JSPS KAKENHI Grants JP21K08805
Organisme : Japan Society for the Promotion of Science
ID : JSPS KAKENHI Grants 21K08718

Informations de copyright

© 2023. The Author(s).

Références

Liver Transpl. 2017 Jan;23(1):110-116
pubmed: 27657354
Liver Transpl. 2009 Apr;15(4):427-34
pubmed: 19326410
Transplantation. 2003 Feb 15;75(3 Suppl):S28-32
pubmed: 12589136
Transplant Proc. 2012 Mar;44(2):454-6
pubmed: 22410042
Liver Transpl. 2019 Dec;25(12):1768-1777
pubmed: 31408578
Liver Transpl. 2010 Nov;16(11):1332-3; author reply 1334-5
pubmed: 21031550

Auteurs

Munetoshi Akaoka (M)

Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-Ku, Tokyo, 105-8461, Japan.

Koichiro Haruki (K)

Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-Ku, Tokyo, 105-8461, Japan. haruki@jikei.ac.jp.
ORCID: 0000-0002-1686-3228

Kenei Furukawa (K)

Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-Ku, Tokyo, 105-8461, Japan.

Shinji Onda (S)

Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-Ku, Tokyo, 105-8461, Japan.

Shunta Ishizaki (S)

Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-Ku, Tokyo, 105-8461, Japan.

Masashi Tsunematsu (M)

Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-Ku, Tokyo, 105-8461, Japan.

Yoshihiro Shirai (Y)

Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-Ku, Tokyo, 105-8461, Japan.

Norimitsu Okui (N)

Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-Ku, Tokyo, 105-8461, Japan.

Yoshiaki Tanji (Y)

Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-Ku, Tokyo, 105-8461, Japan.

Toru Ikegami (T)

Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-Ku, Tokyo, 105-8461, Japan.

Classifications MeSH