全内脏反位成年受者的肝移植：病例报告及文献复习
Liver Transplantation in an Adult Recipient With Situs Inversus Totalis: Case Report and Review of the Literature.
作者信息
Tabrizian P, Joseph T T, Radkani P, Cohen E, Facciuto M
机构信息
Department of Transplantation, Recanati/Miller Transplantation Institute, Mount Sinai Medical Center, New York, New York, USA.
Department of Anesthesiology, Mount Sinai Medical Center, New York, New York, USA.
出版信息
Transplant Proc. 2016 Nov;48(9):3163-3166. doi: 10.1016/j.transproceed.2016.06.038.
BACKGROUND
Over the past few decades, reports have demonstrated the feasibility of liver transplantation in adult patients with situs inversus. However, this disease entity remains rare and experience remains limited in adult recipients with situs inversus undergoing transplantation.
METHODS
A 23-year-old woman with situs inversus totalis and end-stage liver disease secondary to congenital biliary atresia was referred to our center and underwent a successful orthotopic liver transplantation.
RESULTS
We report our experience and review the literature. We performed a modified piggy-back technique with cavo-cavostomy. Using a triangulated wide orifice, the suprahepatic cava was anastomosed in an end-to-side fashion. The patient underwent an uneventful hospitalization and recovery.
CONCLUSION
Situs inversus remains a rare condition. Careful perioperative planning, thorough anatomic knowledge of both donor and recipient liver, and use of a variety of different novel techniques can lead to successful outcomes.
背景
在过去几十年中，报告已证明肝移植在患有内脏反位的成年患者中的可行性。然而，这种疾病实体仍然罕见，且在接受移植的患有内脏反位的成年受者中经验仍然有限。
方法
一名23岁患有完全性内脏反位且继发于先天性胆道闭锁的终末期肝病的女性被转诊至我们中心，并接受了成功的原位肝移植。
结果
我们报告了我们的经验并回顾了文献。我们采用改良背驮式技术行腔静脉吻合术。使用三角形宽口，肝上腔静脉以端侧方式吻合。患者住院和恢复过程顺利。
结论
内脏反位仍然是一种罕见情况。仔细的围手术期规划、对供体和受体肝脏的全面解剖知识以及使用各种不同的新技术可带来成功的结果。
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