Cheng Yen CHEN
Current Position
Transplant Surgeon/Attending Surgeon
Taipei Veterans General Hospitalv
Short Topics Session

Topic: The application of cryopreserved homograft vessels in living donor liver transplantation


Using the cryopreserved homograft vessel (CHV) for the reconstruction of the middle hepatic vein (MHV) or right inferior hepatic vein (RIHV) tributaries of a modified right liver graft has been another choice beyond the prosthetic vascular graft (PVG) in living donor liver transplantation (LDLT). Compared to CHV, the PVG is easily available and has excellent short-term patency rates but sometimes has severe complications, like gastric or duodenal penetration or infection after graft thrombosis. Therefore, in recent five years, we used CHV for MHV or RIHV tributaries reconstruction in LDLT whenever possible. Besides, in May 2020, we established a new three-dimensional (3D) simulation model to design the venoplasty of the recipient’s right hepatic vein (RHV) for anastomosis with the CHV conduit and graft RHV reconstructed in one orifice. We defined the 3D era and the conventional era after and before May 2020 and compared the short-term patency rates in these two eras. Seventeen and 27 patients were enrolled in the conventional and 3D eras, and the one-week patency rates were 59% and 67%. However, the cases (n = 7) designed by the 3D simulation model had a higher
patency rate (71%) than those without using the model (65%). In conclusion, CHV is a safe choice for a right liver lobe with MHV or RIHV reconstruction, and the 3D simulation model could enhance its patency rate.