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Selection of portal‐systemic shunts with an eye to subsequent liver transplantation
Author(s) -
Flye M. Wayne
Publication year - 1988
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.1840080643
Subject(s) - medicine , contraindication , shunt (medical) , portal hypertension , liver transplantation , surgery , hemodynamics , portal venous pressure , splenectomy , transplantation , perfusion , portacaval shunt , cardiology , cirrhosis , spleen , pathology , alternative medicine
Patent distal splenorenal shunts (Warren shunt) have been reported to cause decreases in the portal perfusion pressure and the total hepatic blood flow. Such hemodynamic alterations could have adverse effects on the transplanted liver. The experience with hepatic replacement in four patients with patent Warren shunts is reported. Operative findings were phlebosclerotic portal veins of small size and diminished portal blood flows. Hepatofugal collateral channels created by the construction of the Warren shunt were eliminated by division of the shunt and splenectomy in three patients and splenectomy alone in the other. All patients recovered. A Warren shunt is not a contraindication for transplantation.