Living donor liver transplantation for Budd‒Chiari syndrome with right posterior segment graft and patch plasty using the superficial femoral vein: a case report
Autor: | Wataru Nakanishi, Mineto Ohta, Koji Miyazawa, Toshiaki Kashiwadate, Shigehito Miyagi, Takashi Kamei, Michiaki Unno, Norikazu Une, Yoshikatsu Saitoh, Kengo Sasaki, Kazuaki Tokodai, Norifumi Kanai, Atsushi Fujio |
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Rok vydání: | 2021 |
Předmět: |
Budd‒Chiari syndrome
medicine.medical_specialty Right hepatic vein RD1-811 business.industry Living donor liver transplantation Femoral vein Case Report Right posterior segment graft Anastomosis medicine.disease Inferior vena cava Surgery Stenosis medicine.vein cardiovascular system Right posterior Budd–Chiari syndrome Superficial femoral vein Medicine business |
Zdroj: | Surgical Case Reports, Vol 7, Iss 1, Pp 1-7 (2021) Surgical Case Reports |
ISSN: | 2198-7793 |
Popis: | Background In living donor liver transplantation (LDLT) for patients with Budd‒Chiari syndrome (BCS), there are several concerns about reconstruction of the inferior vena cava (IVC) and hepatic veins. Herein, we report the case of a patient with BCS who underwent LDLT with right posterior segment graft (RPSG) and patch plasty for reconstruction of the hepatic venous outflow, using the patient’s own superficial femoral vein (SFV). Case presentation A 19-year-old man, who was diagnosed with primary BCS, underwent LDLT. His main hepatic veins were totally obstructed, and membranous stenosis was seen in the IVC. The LDLT donor was his mother; however, liver volumetric analysis showed that only her RPSG was appropriate. In the recipient surgery, 16 cm of the left SFV was harvested and was cut longitudinally and opened. The right hepatic vein (RHV) of the RPSG was anastomosed to the sidewall of the SFV graft. After explantation of native diseased liver was completed, the stenotic and thickened wall of the IVC was widely resected, and a large anastomotic orifice was created. Patch cavoplasty was performed with the RHV‒SFV graft patch. After portal reperfusion started, hepatic venous outflow was satisfactory, and there was no venous graft congestion. Both his postoperative course and his long-term course after discharge were uneventful. Conclusions In LDLT for BCS patients, ingenuity is required for the reconstruction of venous outflow. The SFV patch can be safely harvested from liver transplant recipients and is suitable for venous reconstruction. In addition, RPSG is an alternative type of liver graft for LDLT if a conventional right- or left-lobe graft cannot be used. |
Databáze: | OpenAIRE |
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