Successful treatment of pulmonary hypertension secondary to congenital extrahepatic portocaval shunts (Abernethy type 2) by living donor liver transplantation after surgical shunt ligation.
In this report, we describe a living donor liver transplantation (LDLT) in a patient (7-year-old boy) with Abernethy type 2 congenital extrahepatic portocaval shunts (CEPS). This patient underwent a surgical shunt ligation as the first treatment for pulmonary hypertension; pulmonary hypertension was improved and controlled successfully 4 years after the first operation. However, pulmonary hypertension recurred gradually because of multiple intrahepatic portosystemic shunts; therefore, LDLT was performed as a radical treatment of intrahepatic portosystemic shunts. His pulmonary arterial pressure was also controlled 22 months after LDLT, the postoperative continuous intravenous prostaglandin I(2) (PGI(2)) treatment could be withdrawn successfully. We suggest that clinicians carefully follow up the recurrent portosystemic shunt and cardiopulmonary disorders secondary to Abernethy type 2 CEPS.
Iida
Taku
T
Department of Hepatobiliary Pancreas and Transplant Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan. itaku@kuhp.kyoto-u.ac.jp
Ogura
Yasuhiro
Y
Doi
Hiraku
H
Yagi
Shintaro
S
Kanazawa
Hiroyuki
H
Imai
Hisashi
H
Sakamoto
Seisuke
S
Okamoto
Shinya
S
Uemoto
Shinji
S
D002648:Child; D002675:Child, Preschool; D011464:Epoprostenol / Q000008:administration & dosage; D005402:Fistula / Q000601:surgery; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy / Q000601:surgery*; D008026:Ligation; D016031:Liver Transplantation / Q000379:methods; D019520:Living Donors; D008297:Male; D011169:Portal Vein / Q000002:abnormalities; D011170:Portasystemic Shunt, Surgical / Q000379:methods; D014682:Vena Cava, Inferior / Q000002:abnormalities
D011464:Epoprostenol