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  • Title: Venous outflow reconstruction using a polytetrafluoroethylene (PTFE) graft in right lobe living donor liver transplantation: A single center study.
    Author: Singhal A, Makki K, Chorasiya V, Khan AA, Mohamed Q, Ahmad F, Srivastava A, Vij V.
    Journal: Surgery; 2021 Jun; 169(6):1500-1509. PubMed ID: 33642052.
    Abstract:
    BACKGROUND: Venous outflow reconstruction is very important especially in right lobe living donor liver transplantation without middle hepatic vein. Various interposition (venous or synthetic) grafts have been recommended for reconstruction of anterior sector tributaries. METHODS: We aimed to describe our surgical technique and analyze anterior sector venous reconstruction using expanded polytetrafluroethylene graft. Retrospective analysis of prospectively collected data for 760 primary right lobe living donor liver transplantations performed at our institute between December 2011 and June 2018. Reconstruction of anterior sector: expanded polytetrafluroethylene (group A, n = 705) and autologous vein (group B, n = 55). RESULTS: Pretransplant characteristics were comparable among both groups. Group A has significantly lower cold ischemia time (68.7 ± .3.5 minutes vs 127.8 ± 7.2 minutes; P < .001) and anhepatic time (116.3 ± 5.5 minutes vs 190.81 ± 9.35 minutes; P < .001) compared with group B. There was no difference in recovery pattern of liver functions, morbidity, and mortality between the 2 groups. One- and 6-month patency rates of interposition grafts were 97.6% and 84.4% (group A) and 96.4% and 78.1% (group B), respectively. CONCLUSION: In centers with limited access to homologous or autologous vascular grafts, use of expanded polytetrafluroethylene graft for anterior sector venous outflow reconstruction in right lobe living donor liver transplantation is a viable option with excellent patency and patient outcomes.
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