Premium
Left renal vein ligation for large splenorenal shunt during liver transplantation
Author(s) -
Tang Rui,
Han Dongdong,
Li Modan,
Shen Shan,
Huang Xin,
Zhao Wenping,
Dong Jiahong
Publication year - 2017
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.14044
Subject(s) - medicine , ligation , liver transplantation , surgery , shunt (medical) , portacaval shunt , hepatic encephalopathy , transplantation , splenic vein , liver function , splenectomy , anastomosis , encephalopathy , portal hypertension , cirrhosis , spleen
Adequate hepatopetal portal vein blood flow is obligatory to ensure proper liver function after liver transplantation. Large collateral veins as shunts impair portal vein flow and even cause hepatofugal blood flow and portal steal syndrome. In particular, splenorenal shunts in liver transplant recipients can lead to allograft dysfunction and possible allograft loss or hepatic encephalopathy. Restoration of portal flow through left renal vein ligation ( LRVL ) is a treatment option, which is much easier compared to splenectomy, renoportal anastomosis and shunt closure, but bears the risk of moderate and temporary impairment of renal function. In addition, a patent portal vein is mandatory for LRVL . However, although LRVL has been reported to be an effective, safe and easy method to control portacaval shunts and increase hepatopetal flow in some studies, indications and safety are still not clear. In this review, we summarize existing studies on LRVL during liver transplantation.