Clinical application of piggyback liver transplantation and modified surgery

Orthotopic liver transplantation (OLT) was first implemented by Starzl in 1963. With the development of liver transplantation, Tzaris was the first to report piggyback liver transplantation (PBLT) in 1989. The fundamental difference between OLT and PBLT: end to end vascular anastomosis between the donor and recipient is performed after diseased liver resection with the posthepatic inferior vena cava in OLT, while PBLT is to preserve the recipient′s hepatic vein and end to end vascular anastomosis between interior vena cava of donor and shaped hepatic vein is performed. However in the clinical practice, the above two techniques cannot meet the needs of clinical liver transplantation technology. Since 1993 the author has implemented a series of improvements in liver transplantation technology based on PBLT and performed ameliorated piggyback liver transplantation (APBLT). This article focuses on the technical characteristics and clinical application of APBLT. Key words: Liver diseases; Liver transplantation; Orthotopic liver transplantation; Piggyback live transplantation; Ameliorated piggyback liver transplantation; Clinical application