Results of End-to-end Cavocavostomy during Adult LiverTransplantation

The results of end-to-end cavocavostomyduring adult liver transplantation were analyzed with special regard tocaval complications. In a series of 1000 liver transplants, we observed17 patients who suffered from postoperative caval obstruction (6patients) or caval stenosis (11 patients), for an incidence of 1.7%.Surgical therapy was performed in 10 patients (58.8%), and 5 patientsrequired retransplantation (29.4%). Four patients died during thelater postoperative course. Two fatalities were related to cavalcomplications, resulting in a mortality rate of 11.8%. Our resultsindicate that end-to-end cavocavostomy is a safe technique forcavocaval anastomosis. For only a few exceptions, such as pediatrictransplantation, reduced size livers, or size mismatch between donorand recipient, should alternative techniques such as end-to-side orside-to-side cavocavostomy be performed.