Liver transplantation in patients with situs inversus.
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.
Watson
C J
CJ
Department of Surgery, Addenbrooke's Hospital, Cambridge, UK.
Rasmussen
A
A
Jamieson
N V
NV
Friend
P J
PJ
Johnston
P S
PS
Barnes
N D
ND
Calne
R Y
RY
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*