Patency of Hemashield grafts versus ringed Gore-Tex grafts in middle hepatic vein reconstruction for living donor liver transplantation

Backgrounds/Aims: Owing to the short supply of homologous vein allografts, we previously used ringed Gore-Tex vascular grafts for middle hepatic vein (MHV) reconstruction in living donor liver transplantation. When ringed Gore-Tex grafts became unavailable, we used Hemashield vascular grafts. This study aimed to compare the patency and complication rates of Hemashield and ringed Gore-Tex grafts. Methods: This retrospective two-arm study compared the study group that received Hemashield grafts (n=157) and the propensity score-matched control group that received ringed Gore-Tex grafts (n=157). Results: In the Hemashield and Gore-Tex groups, the recipient age was 54.7 +/- 9.4 and 53.3 +/- 6.3 years; Model for End-stage Liver Disease scores were 15.9 +/- 9.2 and 16.9 +/- 8.3; and graft-recipient weight ratios were 1.07 +/- 0.24 and 1.10 +/- 0.23, respectively. In the Hemashield group, V5 reconstruction was performed using single (n=113, 72.0%), double (n=39, 24.8%), and triple (n=3, 1.9%) anastomoses. The proportion of double and triple anastomoses for V5 and V8 was higher in the Hemashield group than in the Gore-Tex group. Two (1.3%) patients required MHV conduit stenting owing to early thrombosis of the Hemashield graft. There was no difference in conduit occlusion-free patient survival rates between groups (p=0.91). The incidence of accidental conduit migration in the Hemashield and Gore-Tex groups was 0 (0%) and 2 (1.3%), respectively. Conclusions: Hemashield grafts used in MHV reconstruction demonstrated acceptably high short-and mid-term patency rates, no incidences of conduit migration, easy handling, and good flexibility for length adjustment. Therefore, we suggest that the Hemashield graft is the preferentially suitable prosthetic material for MHV reconstruction.