A new surgical technique for hepatic vein reconstruction in pediatric live donor liver transplantation.

The hepatic venous reconstruction is one of the corner stones of pediatric LDLT. However, problems associated with hepatic venous outflow still remain to be an issue. In this study, we aimed at comparing two methods used in hepatic venous reconstruction. Between November 1999 and December 2006, 61 consecutive left lateral segment pediatric LDLT were performed at Ege University Organ Transplant Center, and two methods were used for hepatic venous reconstruction. In the former group (group 1: 32 patients) continuous anastomosis was performed between the donor LHV and common orifice of the recipient HV. In the later group (group 2: 29 patients), the posterior wall of the anastomosis was sutured continuously while the anterior wall was sutured with interrupted sutures. HV thrombosis was detected in one patient and stenosis was detected in four patients in group 1. No hepatic venous outflow obstruction was detected in group 2 (p < 0.05). In both groups, mortality was not associated with hepatic venous outflow obstruction. As our results indicate, the novel technique used in this study is a simple and safe anastomosis procedure that has contributed into overcoming hepatic venous outflow problems in pediatric LDLT.