title: [Portal perfusion with right gastroepiploic vein flow in liver transplant].
abstract: BACKGROUND
  Liver transplantation in patients with liver cirrhosis, portal vein thrombosis, and cavernous transformation of the portal vein, is a complex procedure with high possibility of liver graft dysfunction. It is performed in 2-19% of all liver transplants, and has a significantly high mortality rate in the post-operative period. Other procedures to maintain portal perfusion have been described, however there are no reports of liver graft perfusion using right gastroepiploic vein.
  
  
  METHODS
  A 20 year-old female diagnosed with cryptogenic cirrhosis, with a Child-Pugh score of 7 points (class "B"), and MELD score of 14 points, with thrombosis and cavernous transformation of the portal vein, severe portal hypertension, splenomegaly, a history of upper gastrointestinal bleeding due to oesophageal varices, and left renal agenesis. The preoperative evaluation for liver transplantation was completed, and the right gastroepiploic vein of 1-cm diameter was observed draining to the infrahepatic inferior vena cava and right suprarenal vein. An orthotopic liver transplantation was performed from a non-living donor (deceased on January 30, 2005) using the Piggy-Back technique. Portal vein perfusion was maintained using the right gastroepiploic vein, and the outcome was satisfactory. The patient was discharged 13 days after surgery.
  
  
  CONCLUSIONS
  Liver transplantation was performed satisfactorily, obtaining an acceptable outcome. In this case, the portal perfusion had adequate blood flow through the right gastroepiploic vein.
authors.affiliation: Unidad de Trasplantes, Unidad Médica de Alta Especialidad, Hospital de Especialidades del Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México.
authors.forename: Federico
authors.initials: F
authors.lastname: Mendoza-Sánchez
authors.affiliation: Departamento de Cirugía General, Unidad Médica de Alta Especialidad, Hospital de Especialidades del Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México.
authors.forename: Francisco
authors.initials: F
authors.lastname: Javier-Haro
authors.affiliation: Unidad de Investigación en Epidemiología Clínica, Unidad Médica de Alta Especialidad, Hospital de Especialidades del Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México.
authors.forename: Diego Federico
authors.initials: DF
authors.lastname: Mendoza-Medina
authors.affiliation: Unidad de Investigación en Epidemiología Clínica, Unidad Médica de Alta Especialidad, Hospital de Especialidades del Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México.
authors.forename: Alejandro
authors.initials: A
authors.lastname: González-Ojeda
authors.affiliation: Unidad de Investigación en Epidemiología Clínica, Unidad Médica de Alta Especialidad, Hospital de Especialidades del Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México.
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Cortés-Lares
authors.affiliation: Unidad de Investigación en Epidemiología Clínica, Unidad Médica de Alta Especialidad, Hospital de Especialidades del Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México. Electronic address: clotilde.fuentes@gmail.com.
authors.forename: Clotilde
authors.initials: C
authors.lastname: Fuentes-Orozco
mesh_terms: D000015:Abnormalities, Multiple; D001783:Blood Flow Velocity; D000072226:Computed Tomography Angiography; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000601:surgery; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000601:surgery; D008102:Liver Circulation; D008103:Liver Cirrhosis / Q000150:complications / Q000601:surgery; D016031:Liver Transplantation / Q000379:methods*; D011168:Portal System / Q000000981:diagnostic imaging / Q000601:surgery*; D011169:Portal Vein / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology; D013163:Splenomegaly / Q000150:complications; D014680:Veins / Q000000981:diagnostic imaging / Q000601:surgery; D014682:Vena Cava, Inferior; D020246:Venous Thrombosis / Q000150:complications; D055815:Young Adult
keywords: Cavernous transformation; Cirrosis hepática; Liver Cirrhosis; Liver transplantation; Portal vein; Thrombosis; Transformación cavernomatosa; Trasplante hepático; Trombosis; Vena porta