Novel use of percutaneous thrombosuction to rescue the early thrombosis of the conduit vein graft after living donor liver transplantation  Kuo-Shyang.

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Presentation transcript:

Novel use of percutaneous thrombosuction to rescue the early thrombosis of the conduit vein graft after living donor liver transplantation  Kuo-Shyang Jeng, MD, FACS, Chun-Chieh Huang, MD, Hao-Yuan Tsai, MD, Jung-Cheng Hsu, MD, Cheng-Kuan Lin, MD, Kuo-Hsin Chen, MD  Journal of Vascular Surgery Cases and Innovative Techniques  Volume 4, Issue 3, Pages 204-209 (September 2018) DOI: 10.1016/j.jvscit.2018.04.006 Copyright © 2018 The Author(s) Terms and Conditions

Fig 1 a, Computed tomography images of the donor's liver demonstrate the right hepatic vein and V5 tributary of middle hepatic vein. b, Computed tomography images of the donor's liver demonstrate the right hepatic vein and V8 tributary of middle hepatic vein. Journal of Vascular Surgery Cases and Innovative Techniques 2018 4, 204-209DOI: (10.1016/j.jvscit.2018.04.006) Copyright © 2018 The Author(s) Terms and Conditions

Fig 2 a, A small vascular patch to set up an artificial wall for V5 to increase the feasibility of anastomosis with the vascular conduit graft. (For V8, a similar technique was used). b, The vascular conduit for hepatic vein reconstruction. The side a is the site of anastomosis with V5 (yellow); b, anastomosis with V8 (green); c, anastomosis with inferior hepatic vein; and d, conduit opening combined with right hepatic vein opening. c, The conduit with the c opening preparing for anastomosis with right hepatic vein of recipient. Journal of Vascular Surgery Cases and Innovative Techniques 2018 4, 204-209DOI: (10.1016/j.jvscit.2018.04.006) Copyright © 2018 The Author(s) Terms and Conditions

Fig 3 The changing trend of liver function in the process. The arrow points to the date of catheter thrombosuction of the vein V5 thrombus. (a), Ammonia; (b), bilirubin; (c) aspartate transaminase (AST); (d), alanine transaminase (ALT). Journal of Vascular Surgery Cases and Innovative Techniques 2018 4, 204-209DOI: (10.1016/j.jvscit.2018.04.006) Copyright © 2018 The Author(s) Terms and Conditions

Fig 4 Computed tomography scan of the recipient's liver showed thrombosis of the graft vascular conduit (including V5 and V8) reconstructed with joining of right hepatic vein orifice on inferior vena cava demonstrated by volume rendered display (a) and curved multiplanar reconstruction (b). c, Catheter thrombosuction was performed inside the vein graft to remove the thrombosis. d, Recanalization of the intrahepatic venous branch at V5 of the venous graft after thrombosuction. Journal of Vascular Surgery Cases and Innovative Techniques 2018 4, 204-209DOI: (10.1016/j.jvscit.2018.04.006) Copyright © 2018 The Author(s) Terms and Conditions