Percutaneous venovenous bypass in orthotopic liver transplantation.

W. K. Washburn, W. D. Lewis, R. L. Jenkins

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Since January 1994, we have used percutaneous placement of both the subclavian and femoral cannulae to establish access for venovenous bypass during orthotopic liver transplantation. Percutaneous subclavian and femoral cannulae were used in 36 patients of which 5 had portal decompression by placement of a cannula in inferior mesenteric vein percutaneously through the abdominal wall. Intraoperative placement of the subclavian cannula is facilitated by placing a subclavian central venous line before the abdominal incision. One patient underwent exploration for femoral vein bleeding early in our experience. Another patient sustained hypotension as a result of a kinked subclavian cannula. In 4 patients, early in this experience, we had difficulty placing the subclavian cannula and resorted to axillary vein cut-down. There were no episodes of deep venous thrombosis detected by routine postoperative duplex ultrasonography. Minimum and maximum flow rates were significantly better (P < .01), with percutaneously placed cannulae in comparison to a control group of patients who underwent transplantation in whom we used the standard venous cut-down approach with a #7 Gott shunt (2.14 and 3.17 L/min v 1.65 and 2.41 L/min, respectively). Percutaneous placement of cannulae for venovenous bypass during liver transplantation is quick, safe, and effective. We would advocate this technique as an alternative approach for patients in whom bypass is deemed necessary.

Original languageEnglish (US)
Pages (from-to)377-382
Number of pages6
JournalLiver transplantation and surgery : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
Volume1
Issue number6
StatePublished - Nov 1995
Externally publishedYes

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Liver Transplantation
Thigh
Axillary Vein
Mesenteric Veins
Femoral Vein
Cannula
Abdominal Wall
Decompression
Venous Thrombosis
Hypotension
Ultrasonography
Transplantation
Hemorrhage
Control Groups

ASJC Scopus subject areas

  • Hepatology
  • Surgery

Cite this

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