The use of Dacron graft for cavo-cavostomy in orthotopic liver transplantation
The use of Dacron graft for cavo-cavostomy in orthotopic liver transplantation
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DOI：
10.1097/tp.0b013e3181642d1e
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发表时间：
2008-02-27
期刊：
影响因子：
6.2
通讯作者：
Ranjan, Dinesh
中科院分区：
文献类型：
--
作者：
Jeon, Hoonbae;McHugh, Patrick P.;Ranjan, Dinesh
原位肝移植中原位吻合的标准方法有端端“间置”技术和端侧“背驮”技术。我们证明，如果不能使用传统的吻合术，将同种异体肝移植物与涤纶腔静脉移植物吻合是一种可行的解决方案。一名55岁男性因酒精性肝硬化导致终末期肝衰竭，接受了原位肝移植;然而，受体肝切除术期间的术中并发症使自体腔静脉无法挽救。此外，供体腔静脉太短，无法桥接腔静脉缺损进行间置。因此，我们使用Dacron作为原位移植物以跨越差距，随后以背驮方式将同种异体移植物与人工移植物吻合。患者术后情况良好;唯一的主要并发症是晚期吻合口狭窄，通过球囊扩张成功治疗。不幸的是，尽管移植物功能良好，但患者在移植后10个月复发并死亡。
The end-to-end "interposition" technique and end-to-side "piggyback" technique are standard approaches to in situ anastomosis during orthotopic liver transplantation. We demonstrate that anastomosis of liver allograft to a Dacron vena cava graft can be a feasible solution if traditional anastomoses cannot be used. A 55-year-old man with end-stage liver failure from alcoholic cirrhosis underwent orthotopic liver transplantation; however, an intraoperative complication during recipient hepatectomy rendered the native vena cava unsalvageable. In addition, the donor vena cava was too short to bridge the caval defect for interposition. We therefore used Dacron for an in situ graft to span the gap, with subsequent anastomosis of the allograft to the prosthetic graft in piggyback fashion. The patient did well postoperatively; his only major complication was late anastomotic stenosis, which was treated successfully with balloon dilatation. Unfortunately the patient became recidivous and expired ten months posttransplant, despite indications of satisfactory allograft function.