Thrombosed Cavo-Portal Hemi-Transposition Salvaged by Digital Subtraction Angiography and Self Expanding Metallic Stent Deployment-Report of First Case and Review of Literature

Abstract

Cavo Portal Hemi-Transposition (CPHT) is a surgical technique used in liver transplantation (LT) to salvage low portal perfusion situations. Although non physiological it is an established surgical technique for over two decades for the aforementioned clinical situation. CPHT also may fail. Our patient was a 6 months old male child with decompensated cirrhosis secondary to extra hepatic biliary atresia. Intraoperatively there was recurrent thrombosis of portal vein anastomosis. Hence portal flow of the graft was salvaged by CPHT. However, in the immediate postoperative period there was thrombosis of CPHT. Emergency angiography and stenting of CPHT was done. At 3 years post LT the child has stable graft function and good quality of life. This is the first case of this kind to be reported in the literature.