Outcome of extra-anatomic vascular reconstruction in orthotopic liver transplantation

Background: Portal venous. and hepatic arterial reconstruction are critical to successful outcomes in orthotopic liver transplantation (OLT). With por tal vein thrombosis or inadequate hepatic arterial inflow, extra-anatomic v ascular reconstruction is required. However, the clinical outcomes followin g extra-anatomic vascular reconstruction are largely unknown. Methods: To determine the outcomes associated with extra-anatomic vascular reconstruction, we performed a retrospective review of 205 OLT recipients t ransplanted between 1995 and 2000. Results: Extra-anatomic portal venous inflow was based upon the recipient s uperior mesenteric vein using donor iliac vein graft in a retrogastric posi tion (n = 12). Extra-anatomic arterial inflow was based on recipient infrar enal aorta using donor iliac artery graft through the transverse mesocolon (n = 25). OLT with routine anatomic vascular construction served as control (n = 168). Extra-anatomic vascular reconstruction was not associated with increased morbidity, mortality, operating room time, length of stay, or thr ombosis. Conclusion: We conclude that extra-anatomic vascular conduits are associate d with excellent long-term outcomes and provide acceptable alternatives for vascular reconstruction in OLT. (C) 2001 Excerpta. Medica, Inc. All rights reserved.