Migration of the Dacron Interposition Graft for Middle Hepatic Vein Reconstruction in Living Donor Liver Transplantation

Introduction Middle hepatic vein reconstruction has been regarded as one of the method to maintain adequate quality of graft in living donor liver transplantation using right liver. We experienced migration of middle hepatic vein Dacron interposition graft to the adjacent organ. Materials and Methods Between 1996 and 2017 we performed around 850 cases of living donor liver transplantation using right liver. Variety of interposition grafts such as cadaveric cryopresereved vessels, recipient's portal vein, PTFE grand and Dacron graft have been used for middle hepatic vein resonstruction. Results and Discussion 62-year old male patient who suffered from 1.7 cm sized hepatocellular carcinoma, liver cirrhosis associated hepatitis B virus infection was transplanted using right liver from his 33-year old brother-in-law. The middle hepatic vein draining segment 5 was reconstructed using 6 mm in diameter Dacron interposition graft. Post transplantation course was not eventful. However the reconstructed middle hepatic vein flow was not detected at postoperative day 3. Gastrofiberscopy at posttansplantaion 57 month detected migrated Dacron graft in the duodenal lumen without any symptom. Conclusion Artificial graft for middle hepatic vein recostruction can migrate to neighbourng organ with or without complication.