Orthotopic liver transplantation with preservation of the inferior vena cava.

Piggyback orthotopic liver transplantation was performed in 24 patients during a period of 4 months. This represented 19% of the liver transplantation at our institution during that time. The piggyback method of liver insertion compared favorably with the standard operation in terms of patient survival, blood loss, incidence of vascular and biliary complications, and rate of retransplantation. The piggyback operation cannot be used in all cases, but when indicated and feasible its advantages are important enough to warrant its inclusion in the armamentarium of the liver transplant surgeon.