Renoportal anastomosis in right lobe living donor liver transplantation: report of a case.
End-stage liver disease is often accompanied by thrombosis of the portal vein and the formation of splanchnic collateral vessels. Successful liver transplantation in such situations is more likely if the surgeon uses a strategy to establish a graft inflow. A 59-year-old male with a decompensated liver secondary to idiopathic portal hypertension underwent living donor liver transplantation (LDLT) using a right lobe liver graft donated from his son. His portal venous trunk was atrophied and a splenorenal shunt drained the mesenteric venous flow into the systemic circulation. LDLT was performed with renoportal anastomosis (RPA) using his right internal jugular vein as an interposed venous graft, without dissecting the collateral vessels. Although he developed temporary functional hyperbilirubinemia, he was discharged from the hospital 23 days after LDLT. This case suggests that RPA is a useful technique to manage patients with an obstructed portal vein and a splenorenal shunt.
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan.
Yoshihiro
Y
Matsumoto
Toru
T
Ikegami
Kazutoyo
K
Morita
Tomoharu
T
Yoshizumi
Hiroto
H
Kayashima
Ken
K
Shirabe
Yoshihiko
Y
Maehara
D000714:Anastomosis, Surgical / Q000379:methods*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D003097:Collateral Circulation; D058625:End Stage Liver Disease / Q000209:etiology / Q000601:surgery*; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology; D007601:Jugular Veins / Q000637:transplantation; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000601:surgery*; D012082:Renal Veins / Q000601:surgery*; D013152:Splanchnic Circulation; D013162:Splenic Vein / Q000601:surgery; D013927:Thrombosis / Q000150:complications; D016896:Treatment Outcome