Combined en bloc liver/pancreas transplantation in two different patients

Figure 1 Standard en bloc CLPT. The grafts were sewn into the native inferior vena cava. The superior mesenteric vein (SMV) of the graft was anastomosed to the native one. A donor aortic patch with the celiac trunk and the superior mesenteric artery was anastomosed end-to-end to the receptor common hepatic artery (CHA). The gastrointestinal tract was reestablished with a Roux-en-Y duodenojejunostomy. IHCA: Infrahepatic cava anastomosis; BD: Donor bile duct; PV: Donor portal vein; AA: Native abdominal aorta.

Figure 2 Modified en bloc CLPT while retaining the native pancreas. A piggy-back anastomosis of the grafted suprahepatic vena cava onto the native one was performed. A circular donor aortic patch including both the celiac trunk (CT) and the superior mesenteric artery (SMA) was anastomosed end-to-end to a donor aortic tube (DAT) that had been implanted previously on the native abdominal aorta (AA). The donor superior mesenteric vein (SMV) was anastomosed end-to-end to the native portal vein. Roux-Y anastomosis of the grafted distal duodenum and the native proximal jejunum was performed. HA: Donor hepatic artery; BD: Donor bile duct.