title: Meso-Rex bypass as an alternative technique for portal vein reconstruction at or after liver transplantation in children: review and perspectives.
abstract: Direct portal revascularization can be achieved by interposing a vascular graft between the SMV and the Rex recessus (left portal vein system): the MRB. To review indications and results of the procedure in the setting of pediatric liver transplantation, reports were selected from the English literature. Previously reported series were updated to analyze long-term outcome. A new series was added and analyzed as a complementary set of cases. A total of 51 cases were analyzed. With a 96% overall patient survival rate and a 100% long-term patency rate when the IJV is used for the bypass, MRB achieves a very successful physiologic cure of chronic portal hypertension and restores the portal flow into and through the liver graft. It also has been used successfully for primary revascularization of liver grafts, as well as for managing early acute portal vein thrombosis episodes. The use of this procedure in conjunction with other strategies and techniques might be of interest for transplant surgeons, particularly those caring for children.
authors.affiliation: Liver Unit, Department of Pediatric Surgery and Transplantation Centre, Roma, Italy. deville@opbg.net
authors.forename: Jean
authors.initials: J
authors.lastname: de Ville de Goyet
authors.forename: Cristina
authors.initials: C
authors.lastname: Lo Zupone
authors.forename: Chiara
authors.initials: C
authors.lastname: Grimaldi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: D'Ambrosio
authors.forename: Manila
authors.initials: M
authors.lastname: Candusso
authors.forename: Giuliano
authors.initials: G
authors.lastname: Torre
authors.forename: Lidia
authors.initials: L
authors.lastname: Monti
mesh_terms: D000293:Adolescent; D001656:Biliary Atresia / Q000601:surgery / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000601:surgery*; D007223:Infant; D016031:Liver Transplantation / Q000379:methods*; D011169:Portal Vein / Q000473:pathology*; D019651:Plastic Surgery Procedures / Q000379:methods; D016896:Treatment Outcome; D058017:Vascular Grafting / Q000379:methods*; D014656:Vascular Surgical Procedures / Q000379:methods; D020246:Venous Thrombosis / Q000150:complications / Q000601:surgery*