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Augmentation Patch V-venoplasty to Correct Atretic Changes of the Portal Vein During Adult Liver Transplantation

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

The development of large spontaneous portosystemic shunts (PSS) is a common finding in liver cirrhosis. The diversion of the portal flow through PSS directly into the caval system causes progressive liver atrophy and atretic changes of the portal vein. During both living and deceased donor liver transplantation (LT), persistence of large PSS has been associated to portal flow steal phenomena causing decreased patients and graft survival. Atretic changes of the portal vein and large PSS often coexist potentially representing a technical challenge during portal vein reconstruction. We herein describe (with a didactical video) an easy augmentation patch V-venoplasty used in the presence of atretic changes of the portal vein LT.

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References

  1. Ikegami T, Shirabe K, Nakagawara H, et al. Obstructing spontaneous major shunt vessels is mandatory to keep adequate portal inflow in living-donor liver transplantation. Transplantation. 2013;95(10):1270-1277.

  2. Castillo‐Suescun F, Oniscu GC, Hidalgo E. Hemodynamic consequences of spontaneous splenorenal shunts in deceased donor liver transplantation. Liver Transpl. 2011;17(8):891-895

  3. Gomez Gavara C, Bhangui P, Salloum C, et al. Ligation versus no ligation of spontaneous portosystemic shunts during liver transplantation: Audit of a prospective series of 66 consecutive patients. Liver Transplant. 2018;24(4):505-515.

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Authors and Affiliations

  1. Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pôle des Pathologies Digestives, Hépatiques Et de La Transplantation, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Avenue Moliere, Strasbourg, 67098, France

    Pietro Addeo, Olivier Julliard, Caroline Schaaf, Chloe Paul, François Faitot, Caterina Cusumano & Philippe Bachellier

Authors
  1. Pietro Addeo
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  2. Olivier Julliard
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  3. Caroline Schaaf
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  4. Chloe Paul
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  5. François Faitot
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  6. Caterina Cusumano
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  7. Philippe Bachellier
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Contributions

Substantial contributions to the conception or design of the work: PA, OJ, CS, CP, FF, CC and PB.

Acquisition, analysis or interpretation of data for the work: PA, OJ, CS, CP, FF, CC and PB.

Drafting the work or revising it critically for important intellectual content: PA, OJ, CS, CP, FF, CC and PB.

Final approval of the version to be published: PA, OJ, CS, CP, FF, CC and PB.

Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work is appropriately investigated and resolved: PA, OJ, CS, CP, FF, CC and PB.

Corresponding author

Correspondence to Pietro Addeo.

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Addeo, P., Julliard, O., Schaaf, C. et al. Augmentation Patch V-venoplasty to Correct Atretic Changes of the Portal Vein During Adult Liver Transplantation. J Gastrointest Surg 25, 3270–3271 (2021). https://doi.org/10.1007/s11605-021-05105-y

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  • DOI: https://doi.org/10.1007/s11605-021-05105-y

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