A Rare Case in Living Donor Liver Transplantation: Graft-to-Graft of Portal Vein Anastomosis

In RL-LDLT, both APVB and PVT are associated with adverse operative outcomes. Portal vein thrombosis surgical planning depends on the type and extent of portal vein thrombosis. While completely occlusive portal vein thrombosis is associated with higher morbidity and an unfavorable postoperative course, long-term outcomes may be comparable to those of patients without portal vein thrombosis when physiological portal venous inflow can be achieved. In this report, we present a successful liver transplantation in which a living donor graft with APVB was reconstructed on the back table using a homolog portal Y-graft. This reconstructed graft was then anastomosed to a cadaveric interposition graft of the recipient with Yerdel grade 3 portal vein thrombosis, resulting in a graft-to-graft portal vein anastomosis.

Keywords: Jump graft, Jump graft and Y-graft anastomosis, Liver transplantation, Portal vein reconstruction