title: [Liver transplantation in low portal vein flow: separation of portal vein areas with divided portal-venous and arterialized caval-venous liver perfusion. 1. Clinical case report].
abstract: A new method for the performance of a hepatic transplantation in spite of a low portal blood flow situation is described casuistically. In a 36-year-old-patient suffering from liver cirrhosis due to hepatitis B, the portal blood system of the right and left liver parts were divided, the left part was perfused with a low flow of portal blood, the right one with arterialized caval blood. The function of the transplanted liver and the early postoperative course were excellent. During the further postoperative course portal perfusion presumably diminished or stopped on the left side from three weeks and on the right side from two months postoperatively. Nevertheless the general condition of the patient improved continuously; transient elevations of transaminases may reflect the disturbance of portal perfusion. The technique of this arterialized caval blood perfusion of the portal system is presumably applicable also for situations, in which there is no portal blood flow available for perfusion of a liver graft. Thus, the absence of possibility for reconstruction of portal blood inflow or a situation with a hypoplastic portal vein may no longer be considered as a technical contraindication for liver grafting.
authors.affiliation: Klinik für Abdominal- und Transplantationschirurgie der Medizinischen Hochschule Hannover.
authors.forename: R
authors.initials: R
authors.lastname: Pichlmayr
authors.forename: G
authors.initials: G
authors.lastname: Gubernatis
authors.forename: H
authors.initials: H
authors.lastname: Grosse
authors.forename: W
authors.initials: W
authors.lastname: Seitz
authors.forename: S
authors.initials: S
authors.lastname: Mauz
authors.forename: I
authors.initials: I
authors.lastname: Ennker
authors.forename: M
authors.initials: M
authors.lastname: Mei
authors.forename: J
authors.initials: J
authors.lastname: Klempnauer
authors.forename: J
authors.initials: J
authors.lastname: Hauss
authors.forename: E R
authors.initials: ER
authors.lastname: Kuse
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity; D006501:Hepatic Encephalopathy / Q000601:surgery*; D006801:Humans; D006975:Hypertension, Portal / Q000601:surgery; D007084:Iliac Vein / Q000637:transplantation; D008103:Liver Cirrhosis / Q000601:surgery*; D008111:Liver Function Tests; D016031:Liver Transplantation; D008297:Male; D008642:Mesenteric Veins / Q000601:surgery; D008866:Microsurgery / Q000379:methods; D011167:Portacaval Shunt, Surgical / Q000379:methods*; D011169:Portal Vein / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis; D013927:Thrombosis / Q000601:surgery*; D014463:Ultrasonography / Q000379:methods
vernacular_title: Lebertransplantation bei niedrigem Pfortaderfluss: Separation beider Pfortaderbereiche mit getrennter portal-venöser und arterialisiert-caval-venöser Leberperfusion. 1. Klinischer Fallbericht.