BACKGROUND: There has been little focus lately on operative techniques for full graft liver transplantation, and the standard technique is unclear. METHODS: An internet survey addressing the key technical issues was e-mailed to programme directors. RESULTS: Responses were obtained from 93 out of 128 (73%) directors contacted. Programmes performed a median of 60 (8-240) transplants per year. Maximum mean cold time of 13 ± 3 h and maximum median steatosis of 40% (15-90%) were tolerated. The inferior vena cava was preserved by 48% of centres all the time and 43% selectively. European centres used temporary portacaval shunting (42%) four times more often than USA programmes. Venous bypass was always used when not preserving the inferior vena cava by less than 25%, and used selectively by approximately 40% of centres. Portal vein anastomosis with room for expansion (88%), graft hepatic artery to native gastroduodenal/common hepatic artery bifurcation (57%) and bile duct-to-duct (47%) were the favoured techniques. DISCUSSION: A standard international operative technique for deceased donor liver transplantation does not exist, although there is a trend towards inferior vena cava preservation. Donor selection criteria were more homogenous across programmes. As suggested by the high response rate, there likely exists interest to investigate technical variations on an international scale.
BACKGROUND: There has been little focus lately on operative techniques for full graft liver transplantation, and the standard technique is unclear. METHODS: An internet survey addressing the key technical issues was e-mailed to programme directors. RESULTS: Responses were obtained from 93 out of 128 (73%) directors contacted. Programmes performed a median of 60 (8-240) transplants per year. Maximum mean cold time of 13 ± 3 h and maximum median steatosis of 40% (15-90%) were tolerated. The inferior vena cava was preserved by 48% of centres all the time and 43% selectively. European centres used temporary portacaval shunting (42%) four times more often than USA programmes. Venous bypass was always used when not preserving the inferior vena cava by less than 25%, and used selectively by approximately 40% of centres. Portal vein anastomosis with room for expansion (88%), graft hepatic artery to native gastroduodenal/common hepatic artery bifurcation (57%) and bile duct-to-duct (47%) were the favoured techniques. DISCUSSION: A standard international operative technique for deceased donor liver transplantation does not exist, although there is a trend towards inferior vena cava preservation. Donor selection criteria were more homogenous across programmes. As suggested by the high response rate, there likely exists interest to investigate technical variations on an international scale.
Authors: Zoltan Czigany; Marcus N Scherer; Johann Pratschke; Markus Guba; Silvio Nadalin; Arianeb Mehrabi; Gabriela Berlakovich; Xavier Rogiers; Jacques Pirenne; Jan Lerut; Zoltan Mathe; Philipp Dutkowski; Bo-Göran Ericzon; Massimo Malagó; Nigel Heaton; Wenzel Schöning; Jan Bednarsch; Ulf Peter Neumann; Georg Lurje Journal: J Gastrointest Surg Date: 2018-08-10 Impact factor: 3.452
Authors: Christoph Schwarz; Thomas Soliman; Georg Györi; Gerd Silberhumer; Sebastian F Schoppmann; Ferdinand Mühlbacher; Gabriela A Berlakovich Journal: Langenbecks Arch Surg Date: 2015-09-04 Impact factor: 3.445