title: Liver transplantation in patients with situs inversus.
abstract: Seven patients with situs inversus abdominis and one with situs inversus totalis underwent liver transplantation; all are alive at follow-up of between 7 months and 5 years. Two patients required retransplantation within the first 3 weeks (for primary non-function and thrombotic infarction). Seven had additional abnormalities associated with the polysplenia-biliary atresia syndrome. Liver transplantation in these patients involved selection of relatively small donor organs or use of reduced-size grafts. Delayed abdominal wall closure was necessary in two patients and all required a modification of the 'piggy-back' technique of suprahepatic vena caval anastomosis to overcome recipient venous anomalies. Biliary drainage by Roux-en-Y choledochojejunostomy was the preferred technique. Although technically challenging, situs inversus is not a contraindication to liver transplantation and patients should expect full recovery.
authors.affiliation: Department of Surgery, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: C J
authors.initials: CJ
authors.lastname: Watson
authors.forename: A
authors.initials: A
authors.lastname: Rasmussen
authors.forename: N V
authors.initials: NV
authors.lastname: Jamieson
authors.forename: P J
authors.initials: PJ
authors.lastname: Friend
authors.forename: P S
authors.initials: PS
authors.lastname: Johnston
authors.forename: N D
authors.initials: ND
authors.lastname: Barnes
authors.forename: R Y
authors.initials: RY
authors.lastname: Calne
mesh_terms: D000713:Anastomosis, Roux-en-Y; D000714:Anastomosis, Surgical / Q000379:methods; D002648:Child; D002675:Child, Preschool; D000075202:Contraindications; D006801:Humans; D007223:Infant; D016031:Liver Transplantation / Q000379:methods; D012857:Situs Inversus / Q000150:complications*