Triangular anastomosis enhances early patency of small middle hepatic vein tributaries in right lobe living donor liver transplantation.
Triangular anastomosis raised 7-day patency of small hepatic vein tributaries after liver transplant
Triangular anastomosis enhances early patency of small middle hepatic vein tributaries in right lobe living donor liver transplantation.
In right-lobe living donor liver transplantation (living donor liver transplantation) without middle hepatic vein (middle hepatic vein) inclusion, conventional anastomosis results in poor early patency of middle hepatic vein tributaries ≤ 5 mm, which may cause graft congestion and dysfunction, especially in recipients with marginal graft-to-recipient weight ratio (graft-to-recipient weight ratio).
This study evaluated the safety and efficacy of a novel triangular anastomosis for small middle hepatic vein tributary reconstruction.
A single-center, two-period comparative study enrolled 42 adult living donor liver transplantation recipients (May 2019-December 2025).
Small vein branches stayed open at 7 days far more often with the new technique.
Baseline and intraoperative characteristics were well balanced.
Complication and 1-year survival rates were comparable between groups (both P > 0.05).
Within the limitations of this small single-center cohort, triangular anastomosis improves early patency of small middle hepatic vein tributaries and may contribute to earlier graft functional recovery without additional risks.
It is a safe and feasible option for high-risk small venous reconstruction in middle hepatic vein-excluded right-lobe living donor liver transplantation with marginal graft-to-recipient weight ratio.
However, these findings are preliminary, and larger studies with longer follow-up are needed to confirm long-term efficacy.