A simple solution to a technical complication in "piggyback" liver transplantation

Area of Science:

• Hepatobiliary Surgery
• Transplantation Surgery
• Vascular Surgery

Background:

• Piggyback orthotopic liver transplantation is a modified surgical technique.
• Venous outflow obstruction, presenting as Budd-Chiari syndrome, is a potential complication.
• Graft failure is likely if venous outflow obstruction is not rapidly addressed.

Purpose of the Study:

• To describe a technical modification for "piggyback" liver transplantation.
• To present a method for correcting venous outflow obstruction.
• To prevent graft failure in liver transplant recipients.

Main Methods:

• Utilized a "piggyback" orthotopic liver transplantation technique.
• Addressed venous outflow obstruction by creating a specific anastomosis.
• Performed an end-to-side anastomosis between the donor infrahepatic vena cava and the recipient suprarenal vena cava.

Main Results:

• The described anastomosis effectively resolved venous outflow obstruction.
• This technique prevented acute Budd-Chiari syndrome.
• Successful correction of venous outflow obstruction preserved graft viability.

Conclusions:

• End-to-side anastomosis of the donor infrahepatic vena cava to the recipient suprarenal vena cava is an effective solution for venous outflow obstruction in piggyback liver transplantation.
• This method mitigates the risk of graft failure due to vascular complications.
• The technique offers a viable approach to managing a critical complication in liver transplantation.