Objective: To assess the patency of the reconstructed middle hepatic vein (MHV) with cryopreserved vein graft in adult living Donor liver transplantation (LDLT)
Materials and Methods: From 2006 to 2008 Mar, there were 46 adult LDLT cases included with the MHV reconstructed by cryopreserved vein grafts. The branches drained segment 5 (V5) and/or segment 8 (V8) were reconstructed by size > 5 mm. Color Doppler ultrasound (CDUS) was performed to make sure of patency immediately after reperfusion of the graft. If no flow or poor flow velocity and /or monophasic waveform was abnormal, readjust of venous flow or re-do anastomosis may be done under CDUS recheck. CDUS were also performed during the 1st week of postoperative days. Postoperative enhanced CT studies were performed on cases of hyperbilirubinemia
Results: The MHV vein grafts reconstructed were including 15 V5s, 18 V8s and 13 of V5 +V8 in one anastomosis. CDUS had detected normal outflow in 52% (24/46), poor flow velocity (<10cm/sec) or flat waveform in 37% (17/46) and no flow in 11% (5/46). Postoperative complications with marked ascites, pleural effusion and/or persisted hyperbilirubinemia were noted in 7 cases including 3 cases of marginal graft-recipient weight ratio (<1.0). CT scans was performed for complications with significant venous congestion.
Conclusion: Poor outflow of the reconstructed MHV graft detected by CDUS is significant to the graft dysfunction. CDUS is the best modality for evaluation of the outflow patency during and post LDLT.