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Long-term patency and complications of ringed polytetrafluoroethylene grafts used for middle hepatic vein reconstruction in living-donor liver transplantation

BACKGROUND: Homologous vein allografts are adequate for reconstruction of the middle hepatic vein (MHV) in living-donor liver transplantation (LDLT). However, supply is a matter of concern. To replace homologous vein allografts, polytetrafluoroethylene (PTFE) grafts were used. This study aimed to as...

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Autores principales: Jung, I-Ji, Hwang, Shin, Ha, Tae-Yong, Song, Gi-Won, Jung, Dong-Hwan, Ahn, Chul-Soo, Moon, Deok-Bog, Kim, Ki-Hun, Park, Gil-Chun, Yoon, Young-In, Park, Yo-Han, Cho, Hui-Dong, Kwon, Jae-Hyun, Chung, Yong-Kyu, Kang, Sang-Hyun, Lee, Sung-Gyu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society for Transplantation 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9186820/
https://www.ncbi.nlm.nih.gov/pubmed/35770268
http://dx.doi.org/10.4285/kjt.2020.34.1.31
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author Jung, I-Ji
Hwang, Shin
Ha, Tae-Yong
Song, Gi-Won
Jung, Dong-Hwan
Ahn, Chul-Soo
Moon, Deok-Bog
Kim, Ki-Hun
Park, Gil-Chun
Yoon, Young-In
Park, Yo-Han
Cho, Hui-Dong
Kwon, Jae-Hyun
Chung, Yong-Kyu
Kang, Sang-Hyun
Lee, Sung-Gyu
author_facet Jung, I-Ji
Hwang, Shin
Ha, Tae-Yong
Song, Gi-Won
Jung, Dong-Hwan
Ahn, Chul-Soo
Moon, Deok-Bog
Kim, Ki-Hun
Park, Gil-Chun
Yoon, Young-In
Park, Yo-Han
Cho, Hui-Dong
Kwon, Jae-Hyun
Chung, Yong-Kyu
Kang, Sang-Hyun
Lee, Sung-Gyu
author_sort Jung, I-Ji
collection PubMed
description BACKGROUND: Homologous vein allografts are adequate for reconstruction of the middle hepatic vein (MHV) in living-donor liver transplantation (LDLT). However, supply is a matter of concern. To replace homologous vein allografts, polytetrafluoroethylene (PTFE) grafts were used. This study aimed to assess the long-term patency rates and complications of PTFE grafts used for MHV reconstruction of LDLT in a high-volume liver transplantation center. METHODS: We analyzed the patency rates of PTFE-interposed MHV in 100 LDLT recipients and reviewed complications including PTFE graft migration. RESULTS: The mean age was 53.5±5.4 years and male to female ratio was 73:27. Primary diagnoses were hepatitis B virus infection (n=71) and other (n=28). Mean model for end-stage liver disease score was 16.2±8.3. V5 reconstruction was performed as either single anastomosis (n=85) or double anastomoses (n=14). No V5 reconstruction was required in one patient. V8 reconstruction was performed as single anastomosis, double anastomoses, and no reconstruction in 75, 0, and 25 patients, respectively. During a mean follow-up of 6 years, three recipients required early MHV stenting within 2 weeks. After 3 months, there were no episodes of congestion-associated infarct, regardless of MHV patency. Patency rates of PTFE-interposed MHV were 54.0%, 37.0%, and 37.0% at 1, 3, and 5 years, respectively. Unwanted PTFE graft migration occurred in two recipients, and the actual incidence was 2% at 5 years. CONCLUSIONS: PTFE grafts combined with small-artery patches demonstrated acceptably high short- and long-term patency rates. Since the risk of unwanted migration of PTFE graft is not negligibly low, lifelong surveillance is necessary to detect unexpected rare complications.
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spelling pubmed-91868202022-06-28 Long-term patency and complications of ringed polytetrafluoroethylene grafts used for middle hepatic vein reconstruction in living-donor liver transplantation Jung, I-Ji Hwang, Shin Ha, Tae-Yong Song, Gi-Won Jung, Dong-Hwan Ahn, Chul-Soo Moon, Deok-Bog Kim, Ki-Hun Park, Gil-Chun Yoon, Young-In Park, Yo-Han Cho, Hui-Dong Kwon, Jae-Hyun Chung, Yong-Kyu Kang, Sang-Hyun Lee, Sung-Gyu Korean J Transplant Original Article BACKGROUND: Homologous vein allografts are adequate for reconstruction of the middle hepatic vein (MHV) in living-donor liver transplantation (LDLT). However, supply is a matter of concern. To replace homologous vein allografts, polytetrafluoroethylene (PTFE) grafts were used. This study aimed to assess the long-term patency rates and complications of PTFE grafts used for MHV reconstruction of LDLT in a high-volume liver transplantation center. METHODS: We analyzed the patency rates of PTFE-interposed MHV in 100 LDLT recipients and reviewed complications including PTFE graft migration. RESULTS: The mean age was 53.5±5.4 years and male to female ratio was 73:27. Primary diagnoses were hepatitis B virus infection (n=71) and other (n=28). Mean model for end-stage liver disease score was 16.2±8.3. V5 reconstruction was performed as either single anastomosis (n=85) or double anastomoses (n=14). No V5 reconstruction was required in one patient. V8 reconstruction was performed as single anastomosis, double anastomoses, and no reconstruction in 75, 0, and 25 patients, respectively. During a mean follow-up of 6 years, three recipients required early MHV stenting within 2 weeks. After 3 months, there were no episodes of congestion-associated infarct, regardless of MHV patency. Patency rates of PTFE-interposed MHV were 54.0%, 37.0%, and 37.0% at 1, 3, and 5 years, respectively. Unwanted PTFE graft migration occurred in two recipients, and the actual incidence was 2% at 5 years. CONCLUSIONS: PTFE grafts combined with small-artery patches demonstrated acceptably high short- and long-term patency rates. Since the risk of unwanted migration of PTFE graft is not negligibly low, lifelong surveillance is necessary to detect unexpected rare complications. The Korean Society for Transplantation 2020-03-31 2020-03-31 /pmc/articles/PMC9186820/ /pubmed/35770268 http://dx.doi.org/10.4285/kjt.2020.34.1.31 Text en © The Korean Society for Transplantation https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Jung, I-Ji
Hwang, Shin
Ha, Tae-Yong
Song, Gi-Won
Jung, Dong-Hwan
Ahn, Chul-Soo
Moon, Deok-Bog
Kim, Ki-Hun
Park, Gil-Chun
Yoon, Young-In
Park, Yo-Han
Cho, Hui-Dong
Kwon, Jae-Hyun
Chung, Yong-Kyu
Kang, Sang-Hyun
Lee, Sung-Gyu
Long-term patency and complications of ringed polytetrafluoroethylene grafts used for middle hepatic vein reconstruction in living-donor liver transplantation
title Long-term patency and complications of ringed polytetrafluoroethylene grafts used for middle hepatic vein reconstruction in living-donor liver transplantation
title_full Long-term patency and complications of ringed polytetrafluoroethylene grafts used for middle hepatic vein reconstruction in living-donor liver transplantation
title_fullStr Long-term patency and complications of ringed polytetrafluoroethylene grafts used for middle hepatic vein reconstruction in living-donor liver transplantation
title_full_unstemmed Long-term patency and complications of ringed polytetrafluoroethylene grafts used for middle hepatic vein reconstruction in living-donor liver transplantation
title_short Long-term patency and complications of ringed polytetrafluoroethylene grafts used for middle hepatic vein reconstruction in living-donor liver transplantation
title_sort long-term patency and complications of ringed polytetrafluoroethylene grafts used for middle hepatic vein reconstruction in living-donor liver transplantation
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9186820/
https://www.ncbi.nlm.nih.gov/pubmed/35770268
http://dx.doi.org/10.4285/kjt.2020.34.1.31
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