Overcoming the portal steal phenomenon in auxiliary partial orthotopic liver transplantation by modulation of the venous outflow of the native liver.
The main drawback of auxiliary partial orthotopic liver transplantation (APOLT) is the competition of the portal flow between the graft and the native liver, leading to graft failure. In two patients with Crigler-Najjar syndrome type I, the intrahepatic resistance of the native liver was increased by occluding the recipients middle hepatic vein during parenchymal transection, leading the portal flow towards the graft. This new surgical technique could encourage centers to recommence APOLT.
Broering
Dieter C
DC
Department of Hepatobiliary Surgery and Transplantation, University Hospital of Hamburg-Eppendorf, Germany. broering@uke-uni-hamburg.de
Walter
Jessica
J
Bassas
Atef F
AF
D002648:Child; D002675:Child, Preschool; D003414:Crigler-Najjar Syndrome / Q000601:surgery; D006503:Hepatic Veins; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000601:surgery*; D008099:Liver / Q000098:blood supply*; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D008297:Male; D011169:Portal Vein / Q000503:physiopathology; D013536:Suture Techniques; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000209:etiology / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods*