Funneling venoplasty for anomalous graft left hepatic vein in living donor liver transplantation using a split left lateral section graft for an infant patient

Jung-Man Namgoong; Shin Hwang; Tae-Yong Ha; Young-In Yoon; Yong Jae Kwon; Hyunhee Kwon; Kyung Mo Kim; Seak Hee Oh

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자료유형: 학술저널

저자정보: Jung-Man Namgoong (University of Ulsan College of Medicine) Shin Hwang (University of Ulsan College of Medicine) Tae-Yong Ha (University of Ulsan College of Medicine) Young-In Yoon (University of Ulsan College of Medicine) Yong Jae Kwon (University of Ulsan College of Medicine) Hyunhee Kwon (University of Ulsan College of Medicine) Kyung Mo Kim (University of Ulsan College of Medicine) Seak Hee Oh (University of Ulsan College of Medicine)

저널정보: 한국간담췌외과학회 Annals of Hepato-Biliary-Pancreatic Surgery 한국간담췌외과학회지 제25권 제3호

발행연도: 2021.8

수록면: 408 - 413 (6page)

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The left lateral section (LLS) can have an unusual variant left hepatic vein (LHV) anatomy. We present a case of customized funneling venoplasty of the graft LHV in a 22-month-old girl diagnosed with ornithine transcarbamylase deficiency undergoing deceased donor liver transplantation (LT) using a split LLS graft. The split LLS graft weighed 350 g, yielding a graft-to-recipient weight ratio of 3.2%. Notably, the graft LHV opening was located at the graft liver cut surface, which was only 1 cm in size and 2 cm away from the cephalad apex of the LLS graft. Since such a variant location of the small LHV opening was unsuitable for direct anastomosis, we performed a funneling venoplasty using an inferior vena cava fragment homograft obtained from the same donor. The graft implantation was performed according to standard procedures of infant split LT. Follow-up imaging studies showed no vascular complications. The patient recovered uneventfully from the LT operation. She had normal blood test findings, including normal ammonia level. She has been doing well for 6 months after the transplantation. In conclusion, our surgical technique using a funneling venoplasty enabled successful reconstruction of the anomalous graft LHV. Our results suggest that individualized reconstruction techniques should be applied to infant patients undergoing LT using a LLS graft with variant types of graft LHV anatomy.

#Left hepatic vein #Anatomical variation #Venoplasty #Interposition #Left lateral section graft

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