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Technical aspects and outcomes of living donor liver transplantation for pediatric patients with situs inversus
Author(s) -
Vincenzi Rodrigo,
SedaNeto Joao,
Fonseca Eduardo Antunes da,
Ketzer Bernardo Mazzini,
Benavides Marcel,
Cândido Helry Lopes,
Porta Gilda,
Miura Irene Kazue,
Pugliese Renata,
Danesi Vera Baggio,
Guimaraes Teresa Cristina,
Porta Adriana,
Borges Cristian Barbieri,
Kondo Mario,
Chapchap Paulo
Publication year - 2013
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.23611
Subject(s) - medicine , biliary atresia , situs inversus , living donor liver transplantation , liver transplantation , surgery , polysplenia , transplantation , vein
The vascular anomalies encountered in patients with biliary atresia associated with polysplenia syndrome and situs inversus (SI) demand technical refinements when liver transplantation is being performed. The available data describing the technique used in living donor liver transplantation (LDLT) in this population are limited; the short vascular stumps of the donor's liver can impart additional technical difficulties during vascular reconstruction. Here we describe our experience with 9 children with biliary atresia and SI who underwent LDLT. In our series, the retrohepatic vena cava was absent for 7 patients, 7 had a preduodenal portal vein (PV), and 4 had a variant arterial anatomy. The donor's left hepatic vein was anastomosed to the confluence of the recipient's 3 hepatic veins in 7 patients. Vascular grafts were used for PV reconstruction in 3 cases. A left lateral segment graft was used in all but 1 patient who needed a graft reduction. All grafts were placed in the upper left abdomen. There were no vascular complications after transplantation. All patients were alive and well at a median follow‐up of 55 months. In conclusion, LDLT can be successfully performed in pediatric patients with SI. Complex vascular anomalies associated with the use of partial liver grafts obtained from living donors are not associated with an increased occurrence of vascular complications. Liver Transpl 19:431–436, 2013 . © 2013 AASLD.