Abstract
Background
Methods
Results
Figures and Tables
Fig. 1
Illustration of the conjoined unification venoplasty technique. (A) First, the recipient's autologous portal vein (PV) Y-graft was harvested and the crutch of the PV Y-graft was opened (arrows) creating a funnel-shaped vessel graft. (B) A central vein patch is attached between the two sectional PV orifices of the right liver graft, which converts the two PV orifices to one large PV orifice. The crutch-opened PV graft is anastomosed to the unified PV graft. Dotted lines indicate the approximation points for end-to-end anastomosis. (C) The final configuration of the unified PV makes a potbelly-shaped PV confluence. This conjoined PV confluence provides a wider range of tolerance for malalignment (bidirectional arrow) and PV size mismatches.
![kjt-33-106-g001](/upload/SynapseData/ArticleImage/1083kjt/kjt-33-106-g001.jpg)
Fig. 2
Operative photographs of the conjoined unification venoplasty technique applied to the two and three portal vein (PV) orifices. (A) The two PV orifices were unified by a central vein patch from a short PV segment. The crutch-opened autologous PV Y-graft is anastomosed to make a single PV orifice. (B) The three PV orifices were unified by a Y-shaped incised central vein patch from an autologous greater saphenous vein segment. The crutch-opened autologous PV Y-graft is attached to anastomose this enlarged PV graft orifice.
![kjt-33-106-g002](/upload/SynapseData/ArticleImage/1083kjt/kjt-33-106-g002.jpg)
Fig. 3
Sequential changes of the recipient portal vein (PV) reconstructed by the conjoined unification venoplasty technique. (A) The donor PV showed a type III anomaly. (B-D) Two graft PV orifices were unified by a conjoined unification venoplasty. (E-J) Computed tomography portal phase follow-up images showed slight expansion of the anastomotic confluence during the first week, which was reshaped at 1 month. There was no noticeable configurational changes in the streamlined reshaped PV after 1 year.
![kjt-33-106-g003](/upload/SynapseData/ArticleImage/1083kjt/kjt-33-106-g003.jpg)
Notes
Funding/Support This study was supported by the intramural research fund of Asan Medical Center Organ Transplantation Center (2018-01).
This study was supported by research grant from the Korean Society for Transplantation (2019-04-01002-005).
References
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