This study was supported in part by a grant-in-aid for general research (24592004) from the Japanese Ministry of Education, Culture, Sports, Science, and Technology.
Pathological analysis of opened round ligaments as venous patch grafts in living donor liver transplantation
Article first published online: 14 SEP 2013
© 2013 American Association for the Study of Liver Diseases
Volume 19, Issue 11, pages 1245–1251, November 2013
How to Cite
Ikegami, T., Wang, H., Imai, D., Bekki, Y., Yoshizumi, T., Yamashita, Y.-I., Toshima, T., Soejima, Y., Shirabe, K. and Maehara, Y. (2013), Pathological analysis of opened round ligaments as venous patch grafts in living donor liver transplantation. Liver Transpl, 19: 1245–1251. doi: 10.1002/lt.23716
- Issue published online: 28 OCT 2013
- Article first published online: 14 SEP 2013
- Accepted manuscript online: 25 JUL 2013 03:29PM EST
- Manuscript Accepted: 16 JUL 2013
- Manuscript Received: 20 MAY 2013
Although the round ligament, including the umbilical vein, could be used as a venous graft in living donor liver transplantation (LDLT), no studies have determined its appropriate use on the basis of pathological findings. We prospectively examined 19 LDLT cases in which the donor's round ligament was procured and used as a venous graft. The round ligaments were categorized into 3 types based on the CD31 immunohistochemistry of tissue cross-sections: (I) canalized umbilical veins (n = 7 or 36.8%), (II) capillary umbilical vessels (n = 4 or 21.1%), and (III) occluded umbilical veins (n = 8 or 42.1%). After dilatation and incision, the round ligaments provided patch grafts that were 5.8 ± 0.4 cm long and 1.8 ± 1.2 cm wide. However, histological studies showed the absence of fine intimal layers on the dilated round ligaments after mechanical maneuvers. The ligaments were used to cuff the venous orifices in 15 patients (left lobe, n = 8; right lobe, n = 7) and were used as venous bridges in 4 patients (left lobe, n = 2; right lobe, n = 2). We detected no thrombosis at the implant sites after LDLT. Our pathological findings indicate that opened round ligaments can be used safely as venous patch grafts in LDLT. Liver Transpl 19:1245–1251, 2013. © 2013 AASLD.