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Fig. 1. Illustration of the modified piggyback technique to make a large cavocaval anastomosis. After clamping of the suprahepatic and retrohepatic inferior vena cava (IVC), the orifices of the right, middle, and left hepatic vein trunks are opened altogether to make a large single orifice. A 4–5-cm-long longitudinal incision is made at the ventral surface of the retrohepatic IVC to enlarge the anastomotic vein orifice. A 4-cm-long longitudinal incision is also made at the dorsal surface of the graft IVC. These triangular-shaped orifices at the recipient and graft IVCs are well matched, thus being tolerant to extrinsic compression.
Korean J Transplant 2020;34:249~256 https://doi.org/10.4285/kjt.20.0036
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