Hepatic venoplasty to overcome outflow block in living related liver transplantation.

A 14-year-old boy with congenital biliary atresia underwent living related liver transplantation. Because of anatomic variation in donor hepatic vein, there were small and double orifices of hepatic veins in the harvested left hemiliver graft. To minimize the risk of outflow block after reperfusion, the recipient's native hepatic vein was used as an autologous patch for hepatic vein reconstruction. After 3 years of follow-up, the patient is alive and well with normal liver function. Follow-up duplex ultrasound scan showed adequate hepatic vein outflow without signs of late obstruction. The new technique of the autologous vascular patch grafting for successful hepatic vein reconstruction is described.