Better innovate than compromise: A novel hepatic outflow reconstruction technique in pediatric living donor liver transplantation
Corresponding Author
P. Thomas Cherian
Department of HPB and Liver Transplantation, Global Hospitals, Hyderabad, Telangana, India
Institute of Liver Disease & Transplantation, Global Health City, Chennai, Tamil Nadu, India
P. Thomas Cherian, Department of HPB Surgery & Liver Transplantation, Global Hospital, 6-1-1070 Lakdi-ka-Pool, Hyderabad, Telangana 500004, India
Tel.: +91 97 0477 7700
Fax: +91 40 2324 4455
E-mail: [email protected]
Search for more papers by this authorAshish K. Mishra
Department of HPB and Liver Transplantation, Global Hospitals, Hyderabad, Telangana, India
Department of Surgical Gastro and Liver Transplant, Global Hospitals, Hyderabad, Telangana, India
Search for more papers by this authorAshish Bangaari
Department of Liver Transplant Anaesthesia, MIOT Hospital, Chennai, Tamil Nadu, India
Search for more papers by this authorVenugopal Kota
Institute of Liver Disease & Transplantation, Global Health City, Chennai, Tamil Nadu, India
Search for more papers by this authorMohan Sathyanarayanan
Department of Anaesthesiology and Critical Care, Global Hospitals, Hyderabad, Telangana, India
Search for more papers by this authorRavichandra Raya
Department of Anaesthesiology and Critical Care, Global Hospitals, Hyderabad, Telangana, India
Search for more papers by this authorMohamed Rela
Department of HPB and Liver Transplantation, Global Hospitals, Hyderabad, Telangana, India
Institute of Liver Disease & Transplantation, Global Health City, Chennai, Tamil Nadu, India
Insitute of Liver Studies, King's College Hospital, London, UK
Search for more papers by this authorCorresponding Author
P. Thomas Cherian
Department of HPB and Liver Transplantation, Global Hospitals, Hyderabad, Telangana, India
Institute of Liver Disease & Transplantation, Global Health City, Chennai, Tamil Nadu, India
P. Thomas Cherian, Department of HPB Surgery & Liver Transplantation, Global Hospital, 6-1-1070 Lakdi-ka-Pool, Hyderabad, Telangana 500004, India
Tel.: +91 97 0477 7700
Fax: +91 40 2324 4455
E-mail: [email protected]
Search for more papers by this authorAshish K. Mishra
Department of HPB and Liver Transplantation, Global Hospitals, Hyderabad, Telangana, India
Department of Surgical Gastro and Liver Transplant, Global Hospitals, Hyderabad, Telangana, India
Search for more papers by this authorAshish Bangaari
Department of Liver Transplant Anaesthesia, MIOT Hospital, Chennai, Tamil Nadu, India
Search for more papers by this authorVenugopal Kota
Institute of Liver Disease & Transplantation, Global Health City, Chennai, Tamil Nadu, India
Search for more papers by this authorMohan Sathyanarayanan
Department of Anaesthesiology and Critical Care, Global Hospitals, Hyderabad, Telangana, India
Search for more papers by this authorRavichandra Raya
Department of Anaesthesiology and Critical Care, Global Hospitals, Hyderabad, Telangana, India
Search for more papers by this authorMohamed Rela
Department of HPB and Liver Transplantation, Global Hospitals, Hyderabad, Telangana, India
Institute of Liver Disease & Transplantation, Global Health City, Chennai, Tamil Nadu, India
Insitute of Liver Studies, King's College Hospital, London, UK
Search for more papers by this authorAbstract
Pediatric LDLT using donors with unfavorable vascular anatomy is challenging in terms of donor safety, and complexity of reconstruction in the recipient. We describe an innovative technique of hepatic venous outflow reconstruction involving the recipient RHV, in the presence of a rudimentary RHV in the donor. The postoperative course of the donor and recipient was uneventful with satisfactory venous outflow in both. This technique avoided the use of prosthetic material, an important consideration given the recipient age and requirement for growth. This shows that donors previously considered unsuitable for donation can be utilized safely as long as principles of vascular anastomosis are adhered to. Moreover, it highlights that innovation is sometimes necessary to avoid compromise in donor safety.
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