Infrahepatic Terminolateral Cavocavostomy in liver transplant recipientes

Abstract

Introduction: Liver transplantation is the only definitive treatment for terminal liver disease. Intrahepatic terminolateral cavostomy is a proposed technique for liver transplantation and derived from the classic piggyback, used as a single technique or as a resource in cases of obstruction, stenosis or unfavorable anatomy of the hepatic veins, thus providing an alternative for the implantation of the inferior vena cava. Purpose: To describe the experience of a specialized center using infrahepatic terminolateral cavostomy, mainly in terms of intraoperative and postoperative outcomes and complications. Methods: Retrospective study of adult patients who underwent liver transplantation through the infrahepatic terminolateral cavostomy technique from 1999 to 2018. Results: We found 10 patients undergoing the technique, aged 28 to 70 years, classified as eutrophic and overweight and MELD from 10 to 47. In seven patients, infrahepatic terminolateral casvostomy was the only technique chosen and in the others it was associated with another technique. It was not found in any of the patients difficulty in developing the infrahepatic terminolateral cavostomy or intra and postoperative complications resulting from it. Conclusion: The technique used in this study is an alternative to be considered for cava reconstruction, in situations such as anatomical unavailability and complications of outflow from the hepatic veins.