Relationship between hepatic venous outflow obstruction and patterns of hepatic vein drainage into inferior vena cava in piggyback liver transplantation

Cheng Zeng; Qifa YE; Yanfeng Wang; Zhehong Fang; Xiaoyan HU; Ling LI; Yan Xiong

Return

Relationship between hepatic venous outflow obstruction and patterns of hepatic vein drainage into inferior vena cava in piggyback liver transplantation

VernacularTitle:背驮式肝移植术中、术后肝静脉回流梗阻的原因分析
Author: Cheng ZENG ; Qifa YE ; Yanfeng WANG ; Zhehong FANG ; Xiaoyan HU ; Ling LI ; Yan XIONG
Keywords: Hepatic vein classification; Piggyback liver transplantation; Hepatic venous outflow obstruction
From: Chinese Journal of Organ Transplantation 2016;37(10):601-605
CountryChina
Language:Chinese
Abstract: Objective To investigate the relationship between hepatic venous outflow obstruction (HVOO) and patterns of the hepatic vein (HV) drainage into inferior vena cava (IVC) in piggyback liver transplantation (PBLT).Methods A retrospective analysis on 202 cases of PBLT (from May 2000 to Aug.2015) was conducted.The recipients' patterns of HV drainage into WC and the angle ∠COB between the reconstructed outflow and IVC in the cross section were recorded by preoperative 3D reconstruction.And the lengths and diameters of recipients' HVs were measured during operations.The relationship between the incidence of HVOO and patterns of HV drainage into IVC was analyzed.Results There were 3 patterns of HV drainage into IVC:type Ⅰ (n =136),trunk of left and middle HVs;type Ⅱ (n=52),trunk of right and middle HVs;type Ⅲ (n=14):trunk of three HVs.There was no statistically significant difference within the HVs of each type,when the lengths and diameters were compared respectively.However,the angle ∠COB of type Ⅰ [(164 ±10.14)°] was significantly bigger than type Ⅱ [(44 ± 12.2)°] and type Ⅲ [(96 ± 13.1) °] (P＜0.05).Accordingly,the highest incidence of HVOO (23.5％) was foundin type Ⅰ,followed by type Ⅱ (9.6％),and type Ⅲ had the lowest incidence (7.1 ％) (P＜0.05).The correlation coefficient Cramer's V =0.765.Conclusion This study demonstrated that there was preferable relativity between the HVOO incidence and the patterns of HV drainage into IVC.Type I is more likely to have HVOO.Type Ⅲ is the most ideal one for PBLT.