Journal article
Suprahepatic venacavaplasty (cavaplasty) with retrohepatic cava extension in liver transplantation : Experience with first 115 cases
Transplantation, Vol.72(8), pp.1389-1394
2001
DOI: 10.1097/00007890-200110270-00010
PMID: 11685109
Abstract
Background: We first introduced the orthotopic liver transplantation utilizing cavaplasty technique in 1994. This paper describes the surgical technique and assesses the outcome of the cavaplasty OLT.
Methods: The cavaplasty procedure was used in 115 consecutive orthotopic liver transplantations, including six left lateral and two right lobe transplantations, between November 1994 and September 2000. Fifty-three (66.3%) transplantations required femoro-axillary veno-venous bypass in the initial 4 years, whereas only eight (22.9%) needed VB in the subsequent 2 years. Conversion to piggyback or standard technique was not necessary in any patient.
Results: Median results are as follows: operative time 4.5 hr, warm ischemia time 25 min, and blood transfused (packed red blood cells) 6 units. These findings did not differ between first transplantation and retransplantation. There were no perioperative deaths related to the cavaplasty technique. No hepatic venous outflow obstruction was observed, including living-related OLTs. No patient required postoperative hemodialysis for acute renal failure. The median intensive care and hospital stays were 2 days and 10 days, respectively.
Conclusions: The cavaplasty technique requires no retrocaval, hepatic vein, or short hepatic vein dissection, and the inferior vena cava can be preserved, which provides advantages for hepatectomy and easy hemostasis, especially during retransplantation. The wide-open triangular caval anastomosis is easy to perform, allowing short implantation time and size matching and avoiding outflow obstruction. The short implantation time reduces the need for veno-venous bypass. Our experience indicates that the cavaplasty technique can be applied to all patients and is justified by minimal technical complications.
Details
- Title: Subtitle
- Suprahepatic venacavaplasty (cavaplasty) with retrohepatic cava extension in liver transplantation : Experience with first 115 cases
- Creators
- YOU MIN WU - Department of Surgery, University of Iowa College of Medicine, Iowa City, Iowa, United StatesMichael VOIGT - Department of Internal Medicine, University of Iowa College of Medicine, Iowa City, Iowa, United StatesStephen RAYHILL - Department of Surgery, University of Iowa College of Medicine, Iowa City, Iowa, United StatesDaniel KATZ - Department of Surgery, University of Iowa College of Medicine, Iowa City, Iowa, United StatesRou-Yee CHENHSU - Department of Surgery, University of Iowa College of Medicine, Iowa City, Iowa, United StatesWarren SCHMIDT - Department of Internal Medicine, University of Iowa College of Medicine, Iowa City, Iowa, United StatesRachel MILLER - Department of Internal Medicine, University of Iowa College of Medicine, Iowa City, Iowa, United StatesFrank MITROS - Department of Pathology, University of Iowa College of Medicine, Iowa City, Iowa, United StatesDouglas LABRECQUE - Department of Internal Medicine, University of Iowa College of Medicine, Iowa City, Iowa, United States
- Resource Type
- Journal article
- Publication Details
- Transplantation, Vol.72(8), pp.1389-1394
- Publisher
- Lippincott
- DOI
- 10.1097/00007890-200110270-00010
- PMID
- 11685109
- ISSN
- 0041-1337
- eISSN
- 1534-6080
- Language
- English
- Date published
- 2001
- Academic Unit
- Gastroenterology and Hepatology; Pathology; Surgery; Internal Medicine
- Record Identifier
- 9984094725002771
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