Living-Donor Liver Transplantation with Renoportal Anastomosis for Patients with Large Spontaneous Splenorenal Shunts

Marubashi, Shigeru; Dono, Keizo; Nagano, Hiroaki; Gotoh, Kunihito; Takahashi, Hidenori; Hashimoto, Kazuhiko; Miyamoto, Atsushi; Takeda, Yutaka; Umeshita, Koji; Kato, Tomoaki; Monden, Morito

doi:10.1097/01.tp.0000185087.93572.1d

Cited by 33 publications

(31 citation statements)

References 18 publications

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“…We previously reported that PVP remained almost unchanged during the first 3 weeks after right-lobe adult-to-adult LDLT. 15 The present results suggest that PVP remained unchanged (high in the high PVP group) for a long time, and even the liver regeneration and graft function were stabilized after LDLT.…”

Section: Commentsupporting

confidence: 57%

Impact of Graft Size on Postoperative Thrombocytopenia in Living Donor Liver Transplant

Marubashi

Dono²,

Miyamoto³

et al. 2007

Arch Surg

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Section: Commentsupporting

confidence: 57%

Impact of Graft Size on Postoperative Thrombocytopenia in Living Donor Liver Transplant

Marubashi

Dono²,

Miyamoto³

et al. 2007

Arch Surg

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“…In the present patient, having CAPV with a significant splenorenal shunt and without confluence of superior mesenteric vein and splenic vein, the renoportal anastomosis was indicated. Renoportal anastomosis for liver allografts in cases with thrombosed PV and splenorenal/mesenteric-renal shunting has been described with excellent long-term outcome [5–10]. To the best of our knowledge, this is the first report of renoportal anastomosis in LDLT for CAPV.…”

Section: Discussionmentioning

confidence: 99%

Living Donor Liver Transplantation with Renoportal Anastomosis for a Patient with Congenital Absence of the Portal Vein

Uchida

Sakamoto

Shigeta

et al. 2012

Case Reports in Surgery

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A congenital absence of the portal vein (CAPV) is a rare disorder that may lead to an intrapulmonary shunt. A 14-year-old male with CAPV underwent living donor liver transplantation with a left lobe graft from his father. The portal vein reconstruction was achieved with a renoportal anastomosis using an interpositional graft from the native collateral vein, because portal venous system directly drains to the left renal vein without constructing the confluence of superior mesenteric vein and splenic vein. The patient is doing well with a normal liver function and mild hypoxemia.

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“…Most of these jump grafts, however, were fresh vein grafts from deceased donors or the recipients themselves, making the former identical to the native portal vein of the graft liver. 4 In literature, using cryopreserved iliac veins and saphenous vein homografts for PV interposition in seven liver transplant patients has resulted in aneurysm formation in four, stricture in one, and thrombosis in one. 9 Moreover, the 5-year primary patency rate of cryopreserved veins as PV substitutes has been reported to be only 58%, indicating that their use should be limited.…”

Section: Discussionmentioning

confidence: 99%

“…When direct anastomosis does not appear feasible, interposition of a vein graft is performed, usually using autologous large-caliber veins, such as the external iliac, left renal, and internal jugular veins. [2][3][4][5] Spiral winding of the greater saphenous vein patch can provide a large-caliber vein segment. 6 Procurement of autologous vein grafts, however, prolongs time in surgery and may increase the operative risk to patients undergoing major liver resection.…”

Section: Introductionmentioning

confidence: 99%

Portal Vein Interposition Using Homologous Iliac Vein Graft during Extensive Resection for Hilar Bile Duct Cancer

Hwang

Jung

et al. 2007

Journal of Gastrointestinal Surgery

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Although autologous vein grafts have been used for portal vein (PV) reconstruction after long-segment portal vein resection during surgery for hilar bile duct cancer, their procurement prolongs operation time and increases morbidity. Less is known regarding the use of homologous vein grafts. The feasibility of homografts for PV reconstruction was preliminarily evaluated in two patients who underwent curative resection for hilar cholangiocarcinoma. Both patients underwent left lobectomy, caudate lobectomy, bile duct resection, and segmental PV resection and interposition vein graft reconstruction. The iliac vein homografts were obtained from deceased organ donors and stored for 1-2 days in cold preservation solution without freezing. Neither immunosuppression nor anticoagulation was attempted. One patient has shown good PV patency for 27 months. The second patient, who had received adjuvant chemoradiotherapy, showed an asymptomatic waisting at the proximal PV anastomosis site after 4 months, which was relieved by percutaneous balloon dilatation, and has been doing well for 12 months. In conclusion, our preliminary experience with these two patients suggests that cold-stored iliac vein homografts can be considered as PV substitutes after long PV segment resection during extensive hepatobiliary surgery.

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Living-Donor Liver Transplantation with Renoportal Anastomosis for Patients with Large Spontaneous Splenorenal Shunts

Abstract: Living-donor liver transplantation with renoportal anastomosis for the treatment of spontaneous splenorenal shunts in patients with end-stage liver disease is a life-saving and safe technique and should be discussed as a treatment option for patients with splenorenal shunts.

Cited by 33 publications

References 18 publications

Impact of Graft Size on Postoperative Thrombocytopenia in Living Donor Liver Transplant

Impact of Graft Size on Postoperative Thrombocytopenia in Living Donor Liver Transplant

Living Donor Liver Transplantation with Renoportal Anastomosis for a Patient with Congenital Absence of the Portal Vein

Portal Vein Interposition Using Homologous Iliac Vein Graft during Extensive Resection for Hilar Bile Duct Cancer

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