Classical Versus Piggyback Techniques in Liver Transplantation

Trenches in Transplant Surgery · Jul 2, 2025 · 12m

The evolution of liver transplantation techniques has shifted from the classical (conventional) approach, which involves removal of the retrohepatic inferior vena cava (IVC) and typically requires veno-venous bypass, to the piggyback technique, which preserves the recipient’s IVC and offers improved hemodynamic stability. While the classical method remains useful in complex cases (e.g., IVC thrombosis, Budd–Chiari syndrome), the piggyback approach has become the preferred standard due to reduced operative time, lower blood loss, avoidance of VVbypass, and equivalent long-term graft and…