title: Left lobe living donor liver transplantation in an adult patient with situs inversus: technical considerations.
abstract: Situs inversus (SI) is a rare congenital disorder involving a complete mirror image of the thoracic and abdominal organs. Living donor liver transplantation (LDLT) in SI cases poses particular challenges on account of its technical complexity, and only a few cases have been reported. Here, we present an adult with SI who was managed successfully by LDLT using a left lobe graft. Some technical modifications, including triangulated anastomosis of the hepatic vein, were required but no vascular graft was necessary. Graft function and vascular integrity were excellent throughout the postoperative course, although sepsis secondary to wound infection with methicillin-resistant Staphylococcus aureus developed. In conclusion, LDLT using a left lobe graft is a feasible procedure for patients with SI, even for adults. Therefore, this condition, while rare, should not be a contraindication for LDLT. Meticulous preoperative simulation and planning of the vascular reconstruction are important steps in LDLT for this rare anomaly.
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Japan. ysoejima@surg2.med.kyushu-u.ac.jp
authors.forename: Yuji
authors.initials: Y
authors.lastname: Soejima
authors.forename: Makoto
authors.initials: M
authors.lastname: Meguro
authors.forename: Akinobu
authors.initials: A
authors.lastname: Taketomi
authors.forename: Toru
authors.initials: T
authors.lastname: Ikegami
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Yamashita
authors.forename: Noboru
authors.initials: N
authors.lastname: Harada
authors.forename: Shinji
authors.initials: S
authors.lastname: Ito
authors.forename: Hideaki
authors.initials: H
authors.lastname: Uchiyama
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Yoshizumi
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D012857:Situs Inversus / Q000000981:diagnostic imaging* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome