Transplant Technique

Left portal vein anastomosis for left lateral liver lobe segment graft

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  • Technique Description

    • During living donor liver transplantation for a left lateral segment liver graft, proper orientation of the left portal vein anastomosis is critical to achieve the best outcome.
    • This video will demonstrate the technique for a left portal vein anastomosis for a living donor left lateral segment liver graft implantation into a pediatric recipient.
  • Key Points

    • The anastomosis will be completed with a running suture on the back wall, and interrupted stitches on the front wall.
    • Redundancy is permitted to prevent kinking and twisting when the graft is oriented in its final resting position.
    • The posterior wall will be reconstructed with a running suture of 6-0 prolene.
    • Upon completion, the runnning suture will be left loose rather than tightened down, to allow for expansion as the child and liver graft grow.
    • The anterior wall will be reconstructed with interrupted sutures of 6-0 prolene, to allow for expansion as the child and liver graft grow.
    • An alternative technique for anastomosis, a continuous running suture, would be appropriate for an adult transplant where growth is not anticipated.
  • References