SUPERIOR VENA-CAVA RECONSTRUCTION USING AN ILIOCAVAL ALLOGRAFT - A CASE-REPORT

Successful replacements of the superior vena cava (SVC) using autogeno us saphenous or superficial femoral vein or prosthetic grafts have bee n previously performed, but the use of allograft for treatment of SVC syndrome has not been reported. The patient treated by the authors was a forty-one-year-old woman who presented with severe venous congestio n of the head and neck caused by fibrosing mediastinitis. In addition, she had sclerosing cholangitis and chronic liver failure. To treat he r SVC syndrome and provide access for fluid and blood transfusion and for possible venovenous bypass, SVC reconstruction was performed conco mitant to orthotopic liver transplantation. A left innominate vein-rig ht atrial bypass was inserted using an iliocaval allograft. The patien t had an uncomplicated recovery, and at six months after surgery her S VC allograft is widely patent and her transplanted liver is functionin g well. The venous allograft is an excellent conduit for those patient s who are receiving immunosuppression therapy to avoid rejection of a transplanted organ.