Date: Tuesday, June 5, 2018
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.
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