Domino liver transplantation has been performed routinely from livers procured from patients with Familial Amyloidosis (FA). Some technical modifications have been made on the recipient of Amyloid Hepatic Allograft (AHA) to overcome the cuff limitation such as the use of side to side cava-caval anastomosis with closure of the suprahepatic and infrahepatic cava. These technical innovations in the recipient AHA however have no benefit for the FA patient undergoing the hepatectomy and may in fact adversely affect the safety of the harvesting procedure by requiring high dissection of the IVC into the diaphragm. In addition the IVC is removed with the liver, therefore requiring complete supra-renal vena caval clamping and the use of veno-venous bypass. We describe a safe and simple technique to recover the AHA without the IVC.
Affiliations
Keck School of Medicine, University of Southern California, University Hospital, Los Angeles (USA)Division of Hepatobiliary/Pancreatic Surgery and Abdominal Organ Transplantation
Citations
APA
Chicago
FWB
Jabbour, N., Gagandeep, S., Genyk, Y., Selby, R., & Mateo, R. (2006). Caval preservation with reconstruction of the hepatic veins using caval-common iliac bifurcation graft for domino liver transplantation. Liver Transplantation, 12(2), 324-325. https://doi.org/10.1002/lt.20671 (Original work published 2006)