Technical Aspects of Orthotopic Liver Transplantation – A Survey-Based Study within the Eurotransplant, Swisstransplant, Scandiatransplant and British Transplantation Society Networks
1Department of Surgery and Transplantation, University Hospital RWTH, Aachen, Germany
2Department of Solid Organ Transplantation, University Hospital Gent, Gent, Belgium
3Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland
4Department of Solid Organ Transplantation, University Hospital Oslo, Oslo, Norway
5Department of Hepatobiliary Surgery and Transplantation, University College London, London, United Kingdom.
Meeting: 2018 American Transplant Congress
Abstract number: D262
Keywords: Liver, Liver transplantation, Surgical complications
Session Information
Date: Tuesday, June 5, 2018
Session Name: Poster Session D: Surgical Issues (Open, Minimally Invasive): All Organs
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Background: Surgical aspects of ortoptopic liver transplantation (OLT) are widely based on low-level evidence as well as on local institutional protocols. Aim of this study was to depict an overview of technical aspects of OLT within the European transplant community.
Methods: In February 2017, an online-survey with open-ended multiple-choice questions was sent to all ET (n=37), ST (n=3), ScaT (n=5) and BTS (n=7) centers. The survey sought information on center-specific case-load, reconstruction techniques, graft reperfusion, and drain policies. Both qualitative and quantitative methods were used for data-analysis.
Results: Response-rate to our survey was 81% (42/52). 67% of the responding units reported between 25-100 OLT cases/year, meanwhile 9% were high-volume centers with over 100 cases/year. 50% percent of the centers reported piggyback and 40% cava-replacement as their standard technique. In 48% of all centers veno-venous bypass (VVB) or temporary portacaval shunt (PCS) is not applied during OLT. VVB and PCS are routinely implemented in 7%-7%. There was a positive association of case-load and the use of VVB or PCS (vs. no shunt p = 0.04). Portal vein reperfusion is used in 64%, followed by simultaneous 17% and retrograde 12%. 45%-45% of the respondents reported they preference for open- and close-circuit drains, respectively, however, 10% of the centers are having a rather strict drain policy and using intra-abdominal drains only in selected cases. End-to-end choledocho-choledochostomy without drains was the most common performed method of biliary reconstruction (86%). 88% percent of the respondents believe that the technical issues of OLT are not evidence-based and 98% would participate in randomized controlled trials (RCT).
Conclusion: Techniques of OLT vary widely among European centers. Well-designed multicenter RCTs are needed.
CITATION INFORMATION: Czigany Z., Bednarsch J., Böcker J., Meister F., Amygdalos I., Schöning W., Ulmer T., Rogiers X., Dutkowski P., Line P-.D., Malagó M., Neumann U., Lurje G. Technical Aspects of Orthotopic Liver Transplantation – A Survey-Based Study within the Eurotransplant, Swisstransplant, Scandiatransplant and British Transplantation Society Networks Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Czigany Z, Bednarsch J, Böcker J, Meister F, Amygdalos I, Schöning W, Ulmer T, Rogiers X, Dutkowski P, Line P-D, Malagó M, Neumann U, Lurje G. Technical Aspects of Orthotopic Liver Transplantation – A Survey-Based Study within the Eurotransplant, Swisstransplant, Scandiatransplant and British Transplantation Society Networks [abstract]. https://atcmeetingabstracts.com/abstract/technical-aspects-of-orthotopic-liver-transplantation-a-survey-based-study-within-the-eurotransplant-swisstransplant-scandiatransplant-and-british-transplantation-society-networks/. Accessed March 8, 2021.« Back to 2018 American Transplant Congress