Background

There are several options available for caval reconstruction in liver transplantation. Prior reports demonstrated that caval reconstruction technique could affect the renal function. However, there is no clear evidence that any surgical technique is better than another in liver transplantation. The aim of this study was to compare the renal function according to the caval reconstruction techniques in the modern era.

Methods

A retrospective analysis was undertaken of 91 deceased donor liver transplantations in adult patients treated between January 2013 and August 2015 (57 conventional without venovenous bypass (VVB), 34 modified piggyback techniques). Postoperative renal function and need for continuous renal replacement therapy (CRRT) up to first months after transplantation were analyzed.

Results

The need for CRRT was significantly higher in piggyback group than in conventional group (26.3% vs. 5.9%, p = 0.016). During 2 weeks after transplantation, mean serum creatinine was significantly higher in piggyback group than in conventional group. There was no significant difference in serum creatinine between two groups at 1 month. Two cases of venous outflow obstruction occurred in piggyback group (3.5%). There were no significant differences between two groups in terms of warm ischemic time, consumption of blood components, and hospital stay.

Conclusion

With improvement in surgical technique and anesthetic management, conventional techniques can be performed safely without VVB. Conventional technique without VVB might reduce the need for CRRT after liver transplantation.

CITATION INFORMATION: Lee J, Lee J, Song S, Lee J, Kwon S.-K, Han D, Ju M, Choi G, Choi J, Kim M, Kim S, Joo D. Comparing Renal Function After Liver Transplantation: Modified Piggyback versus Conventional Techniques without Venovenous Bypass. Am J Transplant. 2016;16 (suppl 3).

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