ROUTINE USE OF THE PIGGYBACK TECHNIQUE IN PEDIATRIC ORTHOTOPIC LIVER-TRANSPLANTATION

The theoretical advantages of the piggyback technique over conventiona l orthotopic liver transplantation are as follows, (1) Continuous veno us decompression during the anhepatic phase is provided without venove nous bypass, (2) Warm ischemia time can be shortened because there is no need for the infrahepatic vena cava anastomosis. The following repo rt is a review of the authors' experience with this method in children during the past year at their institution, Analyses of intraoperative hemodynamics and blood loss, postoperative renal function, patient an d graft survival, and length of hospital stay have shown excellent res ults. There were no intraoperative deaths, and causes of death and gra ft Boss were not related to the technique, The authors conclude that c hildren who undergo liver transplantation can be very satisfactorily m anaged with the piggyback operation, and this technique may be more ad vantageous than the conventional method. Copyright (C) 1996 by W.B. Sa unders Company.