Urgent living-related liver transplantation using a graft with multiple intrahepatic arterioportal fistulae.
BACKGROUND
We describe the case of a man with intrahepatic arterioportal fistulae located in the left lobe, whose left lateral segment was transplanted into his son who was suffering from severe acute hepatitis B.


METHODS
A male infant with severe acute hepatitis B was considered to be a candidate for liver transplantation. The father was willing to be the donor. Preoperative evaluation of the donor revealed intrahepatic arterioportal fistulae, however, duplex ultrasonography showed normograde portal blood flow. A living-related liver transplantation was performed.


RESULTS
The postoperative course for both the donor and recipient was uneventful. The recipient is free of recurrent hepatitis B and has normograde portal blood flow.


CONCLUSIONS
The present case suggests that there may be a symptomless population with intrahepatic arterioportal fistulae, which cause various degrees of disruption of the portal blood flow. Duplex ultrasonography might be helpful in the evaluation of candidates for liver donation.
Hashikura
Y
Y
First Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Kawasaki
S
S
Miyagawa
S
S
Matsunami
H
H
Terada
M
M
Ikegami
T
T
Nakazawa
Y
Y
Chisuwa
H
H
Kubota
T
T
Makuuchi
M
M
D000328:Adult; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging*; D005500:Follow-Up Studies; D006499:Hepatic Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging; D006509:Hepatitis B / Q000601:surgery*; D006801:Humans; D007223:Infant; D008102:Liver Circulation; D016031:Liver Transplantation / Q000473:pathology; D019520:Living Donors / Q000600:supply & distribution; D008279:Magnetic Resonance Imaging; D008297:Male; D016343:Monitoring, Intraoperative; D011168:Portal System; D011169:Portal Vein / Q000002:abnormalities* / Q000000981:diagnostic imaging; D011859:Radiography; D013997:Time Factors; D018616:Ultrasonography, Doppler, Duplex