title: Sterno-laparotomy and extracorporeal circulation for liver transplantation after repeat-surgery for Budd-Chiari syndrome.
abstract: The surgical management of two patients undergoing living transplantation for Budd-Chiari syndrome is reported. Mesenteriocaval shunt had previously been performed in both cases, followed by transcaval liver resection and hepatoatrial anastomosis after 3 and 5 years, respectively. Liver transplantation was necessitated by deteriorating liver function with portal hypertension and recurrent bleeding. The successful operation was performed via sternolaparotomy. Atrioatrial anastomosis was constructed during cardiopulmonary bypass, considerably simplifying the technical procedure and dramatically reducing blood loss.
authors.affiliation: Department of Surgery, University Hospital, Zürich, Switzerland.
authors.forename: T
authors.initials: T
authors.lastname: Carrel
authors.forename: R
authors.initials: R
authors.lastname: Schlumpf
authors.forename: F
authors.initials: F
authors.lastname: Lagardièr
authors.forename: M
authors.initials: M
authors.lastname: Turina
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D016063:Blood Loss, Surgical / Q000517:prevention & control; D006502:Budd-Chiari Syndrome / Q000601:surgery*; D003135:Common Bile Duct / Q000601:surgery; D004932:Esophageal and Gastric Varices / Q000601:surgery; D005112:Extracorporeal Circulation; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000601:surgery; D006325:Heart Atria / Q000601:surgery; D006498:Hepatectomy; D006499:Hepatic Artery / Q000601:surgery; D006801:Humans; D006975:Hypertension, Portal / Q000601:surgery; D007813:Laparotomy; D016031:Liver Transplantation / Q000379:methods / Q000473:pathology; D008642:Mesenteric Veins / Q000601:surgery; D012086:Reoperation; D013249:Sternum / Q000601:surgery*; D013908:Thoracotomy / Q000379:methods; D014682:Vena Cava, Inferior / Q000601:surgery