Evaluation of orthotopic liver transplantation with no veno-venous bypass

Objective: To assess the feasibility and outcome of orthotopic liver transplantation (OLT) with no veno-venous bypass(v-v bypass) in adult patients. Methods: Between 1999 and 2001, 43 adult patients underwent OLT with v-v bypass, 33 with no v-v bypass. The operation time, anhepatic time, amount of blood loss, amount of blood transfusion, ICU stay days of the two groups were compared; renal function and gastrointestinal function in the two groups were examined. Results: There was no significant difference in mean serum creatinine on day 3 and gas discharge time in patients with v-v bypass or not. With no v-v bypass, the average operation time was 5.7±1.3 hours, anhepatic time was 64±13 minutes, median amount of blood loss in operation was 4000±820 mL, median amount of blood transfused intraoperatively was 4650±910 mL, median ICU stay was 5.7 days; all those were lower or shorter than those with v-v bypass; and these differences between the two groups had statistical significances. Conclusion: OLT with no v-v bypass is safe and can be performed in the majority of adult patients. The practice of liver transplantation with no v-v bypass is associated with shorter total operation time, shorter anhepatic time, lower blood product usage, and shorter ICU stay compared with standard technique of OLT with routine use of v-v bypass.