Parietal Peritoneum as a Novel Substitute for Middle Hepatic Vein Reconstruction During Living Donor Liver Transplantation

Abstract

FIGURE 1. The procedure of harvesting the peritoneal graft for MHV reconstruction. (A) A 4-5 × 10 cm rectangular-shaped peritoneal graft, including the peritoneum and the thin muscular or aponeurotic layer, was retrieved en bloc using a combination of sharp and blunt dissection. (B) The harvested graft on a gauze-wrapped bowl surface while spreading. (C) Rinsing thrice in a saline solution for 2 min. (D) Marking for trimming and cutting. (E) Cutting to create the desired tubular shape. (F) Applying the linear stapler to create a tubular shape. MHV, middle hepatic vein.

Pure Laparoscopic vs. Open Right Hepatectomy in Living Liver Donors: Bench-Surgery Time

“…The bench procedure used for LDLT at our center using a right liver graft has been previously described in detail ( 11 , 12 ). On graft removal, cold perfusion is initiated using the histidine-tryptophan-ketoglutarate (HTK) solution administered via the right portal vein.…”

Peritoneum for Middle Hepatic Vein Conduit During Living Donor Liver Transplantation

“…Cuneyt Kayaalp, MD 1 I have read with interest the article "Parietal Peritoneum as a Novel Substitute for Middle Hepatic Vein Reconstruction During Living Donor Liver Transplantation" published in your journal by Hong et al 1 The use of the parietal peritoneal graft as a venous conduit is not new and has been used as a substitute for several veins for this purpose. It has been shown to be beneficial in a rapid and effective way to repair the venous defects in the portomesenteric veins, hepatic vein, and vena cava.…”

Reply to the Letter to the Editor by Kayaalp

“…1 Nevertheless, this study focused on the use of the parietal peritoneum as a tubular structure, not just a parietal patch, for MHV reconstruction during living-donor liver transplantation (LDLT). 2 Dr Kayaalp actually used an autologous cryopreserved vein graft as a substitute for MHV reconstruction, and there was an outflow problem that resulted in opening the venous conduit and covering a partial patch with the parietal peritoneum. 3 There are several differences between his study and the present study.…”