Computational Simulation-Based Vessel Interposition Reconstruction Technique for Portal Vein Hypoplasia in Pediatric Liver Transplantation

Simple ellipsoid reconstruction technique for a hypoplastic portal vein during pediatric liver transplantation

“…(4) This technique is applied as patch plasty of the native MPV using an interposition patch graft that forms a natural angle connection or whole triangular-shaped interposition vascular graft. However, this is technically demanding, Table 1). time-consuming, and requires an additional interposition graft.…”

“…An anastomosis between the recipient PV and the graft PV/interposition vein graft is prone to twisting and turbulence leading to thrombosis due to the abrupt widening of the PV diameter. (4) In addition, the patency rate of the cryopreserved vessels or artificial graft as an interposition graft is inferior to that of the native one.…”

“…(1,2) Recipients with a hypoplastic PV, which is a common finding in patients with biliary atresia (BA), present with higher rates of complications, such as twisting, thrombosis, and stenosis leading to graft dysfunction. (3,4) LT for children with PV hypoplasia (4 mm in diameter) is challenging.…”

Pathology of Pediatric Gastrointestinal and Liver Disease

“…Hypoplasia of the portal vein often occurs in patients with biliary atresia (Hwang et al 2013 ). Along with atresia and stenosis, hypoplasia of the portal vein results in portal hypertension.…”

Unusual spontaneous porto‐systemic shunt: The importance of diagnosing non‐anatomical porto‐systemic shunts to improve portal flow in pediatric living–related liver transplantation. Case report

“…The degree of flow diversion may vary from a mild decrease to a complete absence of portal inflow, with the consequent portal thrombosis and reversed flow. The importance of identifying those dominant collaterals during the pretransplant evaluation has been very well described in adults, as well as the subsequent need for post‐transplant occlusion, but there is scattered information in this regard in pediatrics. In most cases, after a successful liver transplant, these large shunts tend to disappear due the low portal resistance present in the new liver; nevertheless, the spontaneous closure might be slow, delayed, or might not occur .…”