Open AccessUnusual portal reconstructions after liver transplantation — Case report and review of literature
Author(s) -
Balázs Nemes,
Dénes Görög,
Imre Fehérvári,
Tamás Mándli,
Enikő Sárváry,
László Kopper,
Attila Doros,
János Fazakas
Publication year - 2010
Publication title -
interventional medicine and applied science/interventional medicine and applied science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.195
H-Index - 14
eISSN - 2061-5094
pISSN - 2061-1617
DOI - 10.1556/imas.2.2010.3.8
Subject(s) - medicine , liver transplantation , anastomosis , portal vein , surgery , transplantation , shunt (medical) , radiology
Portal vein reconstruction might be a challenge in certain cases of liver transplantation. The problem usually arises due to small vessels in pediatric transplantation and/or living related donor and split liver transplantation, or as a result of extensive PVT in adult recipients. Authors report a case of a 60-year-old alcoholic cirrhotic patient with reverse portal flow. The standard end to end portal anastomosis did not work well, so a mesoportal shunt with a donor iliac vein conduit was performed first, followed by a cavoportal hemitransposition. After unsuccessful attempts of providing good portal flow, the donor umbilical vein and the iliac conduit was used for portal flow reconstruction as meso-Rex graft. The patient has been doing fine for eight months after her liver transplantation. Unusual types of portal reconstructions consist of meso-portal, umbilico-portal, renoportal anastomoses that are primarily used as rescue techniques. However, it is rare that one has to use them sequentially in the same patient.