title: Inferior mesenteric venous left renal vein shunting for decompression of excessive portal hypertension in adult living related liver transplantation.
abstract: In the present study, we investigated the effect of decompression of excessive portal hypertension by inferior mesenteric venous (IMV) left renal vein shunting in 7 cirrhotic patients with esophago-gastric varices and 2 patients who underwent adult living related donor liver transplantation (ALRDLT). The portal pressure remarkably decreased after shunting in all patients with esophago-gastric varices (388 +/- 42 mm H2O vs. 247 +/- 57 mm H2O; P < .05). It also decreased after a shunt operation in patients who had undergone liver transplantation. We report that the excessive shear stress by portal hypertension after small-for-size LRDLT induces a liver injury and the decompression of portal hypertension by splenic arterial ligation or splenectomy prevents postoperative liver injury following massive hepatectomy and small-for-size LRDLT. Our present studies suggested that IMV left renal vein shunting might prevent postoperative liver injury by partial decompression of excessive portal hypertension following small-for-size LRDLT.
authors.affiliation: Department of Regenerative and Transplant Medicine, Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan. kanishok@med.niigata-u.ac.jp
authors.forename: Y
authors.initials: Y
authors.lastname: Sato
authors.forename: S
authors.initials: S
authors.lastname: Yamamoto
authors.forename: T
authors.initials: T
authors.lastname: Takeishi
authors.forename: T
authors.initials: T
authors.lastname: Kato
authors.forename: H
authors.initials: H
authors.lastname: Nakatsuka
authors.forename: T
authors.initials: T
authors.lastname: Kobayashi
authors.forename: H
authors.initials: H
authors.lastname: Oya
authors.forename: T
authors.initials: T
authors.lastname: Watanabe
authors.forename: H
authors.initials: H
authors.lastname: Kokai
authors.forename: K
authors.initials: K
authors.lastname: Hatakeyama
mesh_terms: D000792:Angiography; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D008638:Mesenteric Arteries / Q000000981:diagnostic imaging; D008875:Middle Aged; D011167:Portacaval Shunt, Surgical; D012082:Renal Veins / Q000601:surgery*; D016896:Treatment Outcome