New surgical approach to large splenorenal shunt in living donor liver transplantation: diversion of SMV and SPV blood flow.
BACKGROUND
The management of a large splenorenal shunt is important because it affects recipient outcome, particularly in living donor liver transplantation.


METHODS
To manage large splenorenal shunts in living donor liver transplantation, we diverted superior mesenteric vein and splenic portal vein blood flow by ligation at the root of the splenic portal vein.


RESULTS
This procedure was applied for five patients in whom superior mesenteric vein blood flow had been completely stolen by a splenorenal shunt preoperatively. Postoperative course was excellent in all cases.


CONCLUSIONS
This technique completely prevents morbidity related to large splenorenal shunts after living donor liver transplantation.
Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata, Okayama, 700-8558, Japan. sada@md.okayama-u.ac.jp
Hiroshi
H
Sadamori
Takahito
T
Yagi
Susumu
S
Shinoura
Yuzo
Y
Umeda
Ryuichi
R
Yoshida
Daisuke
D
Satoh
Daisuke
D
Nobuoka
Masashi
M
Utsumi
Toshiyoshi
T
Fujiwara
D006801:Humans; D008026:Ligation; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008642:Mesenteric Veins / Q000502:physiology*; D011169:Portal Vein / Q000502:physiology*; D012039:Regional Blood Flow; D013164:Splenorenal Shunt, Surgical / Q000379:methods*