{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T07:34:06Z","timestamp":1761896046901},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","license":[{"start":{"date-parts":[[2015,7,24]],"date-time":"2015-07-24T00:00:00Z","timestamp":1437696000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2015,7,24]],"date-time":"2015-07-24T00:00:00Z","timestamp":1437696000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver Transpl"],"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:p>Venous outflow is critical to the success of liver transplantation (LT). In domino liver transplantation (DLT), the venous cuffs should be shared between the donor and the recipient, and the length can be compromised. The aim of this study was to describe and compare the technical options for outflow reconstruction used at our institution. This was a retrospective analysis of 39 consecutive DLT recipients between January 1997 and May 2013. Twenty\u2010seven men and 12 women (mean age, 61.8\u2009\u00b1\u20094.3 years) underwent LT and consented to receive a liver from a donor with familial amyloid polyneuropathy (FAP). The main indications were hepatocellular carcinoma and hepatitis C virus cirrhosis. All recipients underwent transplantation by a piggyback technique. Liver procurement in the FAP donors was performed with the classic technique in 22 patients and with the piggyback technique in the last 17. In these latter cases, for vascular outflow reconstruction, a cadaveric venous graft was interposed between the hepatic vein (HV) stump of the FAP liver and the recipient HV in 11 cases (28%). Since 2011, we have employed arterial grafts to be interposed between the vessels stumps: a tailored arterial graft in 5 patients and an aortic graft in 1 case. There was no postoperative mortality. Arterial and portal complications presented in 2 (5.1) and 4 patients (10.3), respectively. Postoperative outflow complications (post\u2010LT subacute Budd\u2010Chiari syndrome) occurred in 4 patients, and all of them had received a venous interposed graft for reconstruction. The incidence of outflow complications tended to be higher among patients with venous grafts than those with arterial graft interposition. Overall patient survival at 1, 3, 5, and 10 years was 97%, 79%, respectively. Arterial grafts constitute a feasible and safe option for vascular outflow reconstruction in DLT because they are associated with a relatively low incidence of complications. The recently proposed Bellvitge arterial graft technique should be added to the current range of available surgical modalities. <jats:italic toggle=\"yes\">Liver Transpl 21:1051\u20101055, 2015<\/jats:italic>. \u00a9 2015 AASLD.<\/jats:p>","DOI":"10.1002\/lt.24143","type":"journal-article","created":{"date-parts":[[2015,4,8]],"date-time":"2015-04-08T10:59:29Z","timestamp":1428490769000},"page":"1051-1055","source":"Crossref","is-referenced-by-count":9,"title":["Technical options for outflow reconstruction in domino liver transplantation: A single European center experience"],"prefix":"10.1097","volume":"21","author":[{"given":"Sof\u00eda","family":"De la Serna","sequence":"first","affiliation":[{"name":"Liver Transplantation Unit,Hospital Universitari de Bellvitge,Institut d'Investigaci\u00f3 Biom\u00e8dica de Bellvitge,Barcelona,Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Llado","sequence":"additional","affiliation":[{"name":"Liver Transplantation Unit,Hospital Universitari de Bellvitge,Institut d'Investigaci\u00f3 Biom\u00e8dica de Bellvitge,Barcelona,Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emilio","family":"Ramos","sequence":"additional","affiliation":[{"name":"Liver Transplantation Unit,Hospital Universitari de Bellvitge,Institut d'Investigaci\u00f3 Biom\u00e8dica de Bellvitge,Barcelona,Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joan","family":"Fabregat","sequence":"additional","affiliation":[{"name":"Liver Transplantation Unit,Hospital Universitari de Bellvitge,Institut d'Investigaci\u00f3 Biom\u00e8dica de Bellvitge,Barcelona,Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carme","family":"Baliellas","sequence":"additional","affiliation":[{"name":"Liver Transplantation Unit,Hospital Universitari de Bellvitge,Institut d'Investigaci\u00f3 Biom\u00e8dica de Bellvitge,Barcelona,Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juli","family":"Busquets","sequence":"additional","affiliation":[{"name":"Liver Transplantation Unit,Hospital Universitari de Bellvitge,Institut d'Investigaci\u00f3 Biom\u00e8dica de Bellvitge,Barcelona,Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lluis","family":"Secanella","sequence":"additional","affiliation":[{"name":"Liver Transplantation Unit,Hospital Universitari de Bellvitge,Institut d'Investigaci\u00f3 Biom\u00e8dica de Bellvitge,Barcelona,Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nuria","family":"Pelaez","sequence":"additional","affiliation":[{"name":"Liver Transplantation Unit,Hospital Universitari de Bellvitge,Institut d'Investigaci\u00f3 Biom\u00e8dica de Bellvitge,Barcelona,Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaume","family":"Torras","sequence":"additional","affiliation":[{"name":"Liver Transplantation Unit,Hospital Universitari de Bellvitge,Institut d'Investigaci\u00f3 Biom\u00e8dica de Bellvitge,Barcelona,Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antoni","family":"Rafecas","sequence":"additional","affiliation":[{"name":"Liver Transplantation Unit,Hospital Universitari de Bellvitge,Institut d'Investigaci\u00f3 Biom\u00e8dica de Bellvitge,Barcelona,Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2015,7,24]]},"reference":[{"key":"lt24143-bib-0001-20240115","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1111\/j.1478-3231.2008.01684.x","article-title":"Budd\u2010Chiari syndrome: illustrated review of current management","volume":"28","year":"2008","journal-title":"Liver Int"},{"key":"lt24143-bib-0002-20240115","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1097\/00007890-199909150-00009","article-title":"Specific vascular complications of orthotopic liver 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