Technique Description

• During living donor liver transplantation for a left lateral segment liver graft, proper orientation of the left portal vein anastomosis is critical to achieve the best outcome.
• This video will demonstrate the technique for a left portal vein anastomosis for a living donor left lateral segment liver graft implantation into a pediatric recipient.

Key Points

• The anastomosis will be completed with a running suture on the back wall, and interrupted stitches on the front wall.
• Redundancy is permitted to prevent kinking and twisting when the graft is oriented in its final resting position.
• The posterior wall will be reconstructed with a running suture of 6-0 prolene.
• Upon completion, the runnning suture will be left loose rather than tightened down, to allow for expansion as the child and liver graft grow.
• The anterior wall will be reconstructed with interrupted sutures of 6-0 prolene, to allow for expansion as the child and liver graft grow.
• An alternative technique for anastomosis, a continuous running suture, would be appropriate for an adult transplant where growth is not anticipated.

References

• Reducing Pediatric Liver Transplant Complications: A Potential Roadmap for Transplant Quality Improvement Initiatives Within North America

Liver Transplant: Pediatric Left Lateral Lobe (Recipient)



Transplant technique: Microvascular hepatic artery reconstruction