Interposition of retrohepatic inferior vena cava and portal vein using iliac vein homograft in living donor liver transplantation for a pediatric patient with advanced hepatoblastoma
- Author:
Jung-Man NAMGOONG
1
;
Shin HWANG
;
Gil-Chun PARK
;
Hyunhee KWON
;
Suhyeon HA
;
Kyung Mo KIM
;
Seak Hee OH
Author Information
- Publication Type:Case Report
- From: Annals of Liver Transplantation 2026;6(1):56-62
- CountryRepublic of Korea
- Language:English
- Abstract: Replacing the retrohepatic inferior vena cava (IVC) following concurrent resection of the IVC and tumor-involved liver is an emerging surgical technique in living donor liver transplantation (LDLT), particularly for managing hepatocellular carcinomas near the IVC. This approach makes the extent of hepatectomy in LDLT comparable to that of deceased donor liver transplantation. We report a pediatric LDLT case involving IVC and portal vein (PV) replacement with an iliac vein homograft to treat advanced hepatoblastomas. The patient was a 24-month-old girl weighing 9.1 kg, presenting with large, multiple hepatoblastomas infiltrating the retrohepatic IVC and PV. After a 2-week waiting period, a cold-stored iliac vein graft was obtained, and the transplantation was performed using a left lateral section graft from her father.A 4-cm iliac vein homograft was anastomosed between the suprahepatic and suprarenal IVC stumps. The liver graft was implanted following standard procedures, with the PV reconstructed via a telescope-shaped anastomosis using the vein graft interposition. The patient experienced an uncomplicated recovery and is currently receiving scheduled adjuvant chemotherapy. In conclusion, IVC and PV replacement with vein homografts represents a feasible and effective surgical strategy for pediatric LDLT patients with advanced liver malignancies involving vascular invasion.
