Liver transplantation in the presence of situs inversus totalis: application of reduced-size graft.
Because of the anatomical features associated with situs inversus, technical difficulties will be encountered during orthotopic liver transplantation. This report describes the case of a patient with situs inversus totalis and end-stage liver disease from biliary atresia who was treated by segmental orthotopic liver transplantation. The segmental graft was safely placed in the left subphrenic space, and a suitable orientation was obtained for anastomoses of the hilar vessels. Chronic rejection necessitated retransplantation, by the same method, 19 months later. This technique has potential advantages in coping with anatomical obstacles encountered in patients with situs inversus.
Kawamoto
S
S
Queensland Liver Transplant Service, Princess Alexandra Hospital, Woolloongabba, Australia.
Strong
R W
RW
Lynch
S V
SV
Ong
T H
TH
Pillay
S P
SP
Yamanaka
J
J
Balderson
G A
GA
D001656:Biliary Atresia / Q000150:complications; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000175:diagnosis / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D017093:Liver Failure / Q000209:etiology / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D012086:Reoperation; D012857:Situs Inversus / Q000150:complications*; D014019:Tissue Donors
D007166:Immunosuppressive Agents