A New Secured Technique for Suprahepatic Vena Caval Anastomosis in Porcine Liver Transplantation

It is well recognized that hemorrhage or kinking of the suprahepatic vena caval anastomosis is the most fatal complication apparent within 24 hr after orthotopic liver transplantation in the pig. A secured technique for suprahepatic vena caval anastomosis is described in detail herein. Our technique include (1) the use of a diaphragmatic cuff, (2) the closure of phrenic vein orifices using transfixation technique, and (3) the application of "stay-suture" in the orifice of right phrenic vein. This technique has added significantly to the strength of the suprahepatic vena caval anastomosis, and there has been no experiences of uncontrollable bleeding and kinking of suprahepatic vena caval anastomosis in 48 porcine orthotopic transplants of the liver. In conclusion, we believe that this technique described herein is a simplified and secured method to avoid the hemorrhage and kinking of suprahepatic anastomosis in porcine liver transplantation.