Ozdemir Fatih, Kutluturk Koray, Barut Bora, Abbasov Perviz, Kutlu Ramazan, Kayaalp Cuneyt, Yılmaz Sezai
Fatih Ozdemir, Koray Kutluturk, Bora Barut, Cuneyt Kayaalp, Sezai Yılmaz, Department of Surgery, Liver Transplantation Institute of Inonu University, 44280 Malatya, Turkey.
World J Transplant. 2017 Feb 24;7(1):94-97. doi: 10.5500/wjt.v7.i1.94.
For transplant surgeons, end-stage liver disease with portal venous thrombosis and a previous splenorenal shunt (SRS) is a significant challenge during liver transplantation. Thrombosis of the portal vein can be corrected by surgical interventions, such as portal venous thrombectomy or surgical removal of the thrombosed portal vein. Even also placement of a graft between the mesenteric vein and the graft portal vein can be performed. If these maneuvers fail, a renoportal anastomosis (RPA) can be performed to achieve adequate graft inflow. A 51-year-old male patient who had a history of proximal SRS and splenectomy underwent living donor liver transplantation (LDLT) due to cryptogenic cirrhosis. LDLT was performed with RPA using a cadaveric iliac vein graft. The early postoperative course of the patient was completely uneventful and he was discharged 20 d after transplantation. To the best of our knowledge, this was the first patient to receive LDLT with RPA after surgical proximal SRS and splenectomy.
对于移植外科医生而言，终末期肝病合并门静脉血栓形成以及既往有脾肾分流术（SRS），在肝移植过程中是一项重大挑战。门静脉血栓形成可通过手术干预来纠正，如门静脉血栓切除术或手术切除血栓形成的门静脉。甚至还可在肠系膜静脉与移植门静脉之间放置移植物。如果这些操作失败，可进行肾门静脉吻合术（RPA）以实现足够的移植物血流。一名51岁男性患者，有近端SRS和脾切除术病史，因隐源性肝硬化接受了活体供肝肝移植（LDLT）。使用尸体髂静脉移植物通过RPA进行了LDLT。患者术后早期过程完全顺利，移植后20天出院。据我们所知，这是首例在外科近端SRS和脾切除术后接受RPA的LDLT患者。
