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Living donor liver transplantation for biliary atresia complicated by situs inversus: Technical highlights
Author(s) -
Matsubara Kentaro,
Fujimoto Yasuhiro,
Kamei Hideya,
Ogawa Kohei,
Kasahara Mureo,
Ueda Mikiko,
Egawa Hiroto,
Takada Yasutsugu,
Kitajama Masaki,
Tanaka Koichi
Publication year - 2005
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.20584
Subject(s) - biliary atresia , medicine , situs inversus , liver transplantation , living donor liver transplantation , transplantation , gastroenterology , general surgery
Living‐donor liver transplantation (LDLT) has become an established technique to treat children with end‐stage liver disease. Biliary atresia (BA), one of the most common indications for liver transplantation in children, can be associated with situs inversus (SI). In the past, the presence of SI has been considered to be an absolute contraindication for liver transplantation because of the technical difficulties. Recently, some reports of successful diseased‐donor liver transplantation in patients with BA complicated by SI have been published; however, few reports of that with LDLT exist. The technical difficulties involved with LDLT for such cases have not been described. Herein, we present 4 successful cases of LDLT for BA with SI. Complex anomalies associated with SI, such as a hepatic artery arising from the supraceliac aorta, a preduodenal portal vein, and absence of the retrohepatic inferior vena cava, increase the technical difficulties involved with the operation. Additional caution is required in LDLT because a living‐donor graft has short vessels and the availability of vascular grafts from the donor is limited. In conclusion, LDLT for BA complicated by SI can be managed successfully with technical modifications and scrupulous attention. This series represents the largest reported group of patients with BA complicated by SI who underwent a successful LDLT procedure. (Liver Transpl 2005;11:1444–1447.)