title: A central approach to splenorenal shunt in pediatric living donor liver transplantation.
abstract: The management of LSRS is a crucial problem to ensure a sufficient PV flow during pediatric LT. Although several techniques have been indicated to solve this problem, a more appropriate approach to LSRS is still needed in pediatric LT. We herein present a modified surgical approach to the ligation of LSRS via the left side of the IVC for a nine-month-old boy with severe portal hypertension and a history of Kasai portoenterostomy. LSRS was identified and exposed through the left side of the IVC and the dorsal surface of the pancreas from the superior side of the body of the pancreas. The post-operative course was uneventful with an excellent PV flow. The central approach for the ligation of LSRS is worth considering as an alternative procedure for a patient with collateral vessels and a history of multiple laparotomies.
authors.affiliation: Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Uchida
authors.affiliation: Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Akinari
authors.initials: A
authors.lastname: Fukuda
authors.affiliation: Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Matsunami
authors.initials: M
authors.lastname: Masatoshi
authors.affiliation: Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Kengo
authors.initials: K
authors.lastname: Sasaki
authors.affiliation: Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Takanobu
authors.initials: T
authors.lastname: Shigeta
authors.affiliation: Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kanazawa
authors.affiliation: Division of Clinical Pathology, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Atsuko
authors.initials: A
authors.lastname: Nakazawa
authors.affiliation: Division of Radiology, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Miyazaki
authors.affiliation: Division of Radiology, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Nosaka
authors.affiliation: Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Seisuke
authors.initials: S
authors.lastname: Sakamoto
authors.affiliation: Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Mureo
authors.initials: M
authors.lastname: Kasahara
mesh_terms: D001656:Biliary Atresia / Q000150:complications / Q000601:surgery*; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology / Q000601:surgery; D007223:Infant; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D013164:Splenorenal Shunt, Surgical / Q000379:methods*
keywords: living donor liver transplantation; pediatric liver transplantation; portal vein flow; splenorenal shunt