An Elbow Patch Reconstruction Technique for Narrowed Remnant Portal Veins during Right Lobe Living Donor Hepatectomy: A Rescue Surgery

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dc.authoridAkbulut, Sami/0000-0002-6864-7711
dc.authoridBASKIRAN, ADIL/0000-0002-7536-1631
dc.authoridGARZALI, IBRAHIM UMAR/0000-0002-9797-851X
dc.authoridYilmaz, Sezai/0000-0002-8044-0297
dc.authorwosidAkbulut, Sami/L-9568-2014
dc.authorwosidBASKIRAN, ADIL/ABI-2356-2020
dc.authorwosidGARZALI, IBRAHIM UMAR/ITU-1475-2023
dc.contributor.authorUsta, Sertac
dc.contributor.authorAkbulut, Sami
dc.contributor.authorSarici, Kemal Baris
dc.contributor.authorGarzali, Ibrahim Umar
dc.contributor.authorOzdemir, Fatih
dc.contributor.authorGonultas, Fatih
dc.contributor.authorBaskiran, Adil
dc.date.accessioned2024-08-04T20:56:04Z
dc.date.available2024-08-04T20:56:04Z
dc.date.issued2024
dc.departmentİnönü Üniversitesien_US
dc.description.abstractBackground: Treatment of established portal vein narrowing after living donor hepatectomy is challenging. We aimed to present a new approach termed the elbow patch reconstruction technique to correct the narrowed remnant portal vein just or late after right lobe living donor hepatectomy. Methods: Demographic and clinical data of 12 living liver donors with narrowed remnant portal veins and treated with the elbow patch reconstruction technique were prospectively collected and retrospectively evaluated. Anatomic variation of the portal vein was defined in accordance with the Nakamura classification; six of the living liver donors had type A, three had type B, and the remaining three had type C. In eight of the living liver donors with a narrowed remnant portal vein, diagnosis was detected by intraoperative Doppler ultrasonography and visual inspection by experienced transplant surgeons in the living donor hepatectomy procedure. In the remaining four living liver donors, diagnosis was performed postoperatively when elevation of liver enzymes was noticed during the routine liver function test and Doppler US. The diagnosis was confirmed by multidetector computed tomography. Results: Data from nine males and three females aged 18 to 54 years were analyzed. All of the living liver donors were followed up for a median of 1710 days (min-max: 1178-4447 days; IQR: 1516 days), and none of the living liver donors had any structural or functional complications in the portal vein. Conclusions: Narrowing remnant portal veins are rare, but they are a life-threatening complication in living liver donors, and this condition requires urgent management. Image guided interventions and narrowed segment resection with end-to-end anastomosis using a vascular graft carried a potential risk for thrombosis and restenosis. To avoid these complications, we shared a technique named elbow patch reconstruction technique. This technique can be very effective in relieving the narrowing of the remnant portal vein after right lobe living donor hepatectomy.en_US
dc.identifier.doi10.3390/jcm13102924
dc.identifier.issn2077-0383
dc.identifier.issue10en_US
dc.identifier.pmid38792466en_US
dc.identifier.scopus2-s2.0-85194224840en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.urihttps://doi.org/10.3390/jcm13102924
dc.identifier.urihttps://hdl.handle.net/11616/102018
dc.identifier.volume13en_US
dc.identifier.wosWOS:001234284200001en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherMdpien_US
dc.relation.ispartofJournal of Clinical Medicineen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectliving donor liver transplantationen_US
dc.subjectliving donor hepatectomyen_US
dc.subjectportal vein narrowingen_US
dc.subjectelbow patchen_US
dc.subjecthomologous vascular graftsen_US
dc.titleAn Elbow Patch Reconstruction Technique for Narrowed Remnant Portal Veins during Right Lobe Living Donor Hepatectomy: A Rescue Surgeryen_US
dc.typeArticleen_US

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