Watson C J, Rasmussen A, Jamieson N V, Friend P J, Johnston P S, Barnes N D, Calne R Y
Department of Surgery, Addenbrooke's Hospital, Cambridge, UK.
Br J Surg. 1995 Feb;82(2):242-5. doi: 10.1002/bjs.1800820236.
Seven patients with situs inversus abdominis and one with situs inversus totalis underwent liver transplantation; all are alive at follow-up of between 7 months and 5 years. Two patients required retransplantation within the first 3 weeks (for primary non-function and thrombotic infarction). Seven had additional abnormalities associated with the polysplenia-biliary atresia syndrome. Liver transplantation in these patients involved selection of relatively small donor organs or use of reduced-size grafts. Delayed abdominal wall closure was necessary in two patients and all required a modification of the 'piggy-back' technique of suprahepatic vena caval anastomosis to overcome recipient venous anomalies. Biliary drainage by Roux-en-Y choledochojejunostomy was the preferred technique. Although technically challenging, situs inversus is not a contraindication to liver transplantation and patients should expect full recovery.
7例内脏反位和1例全内脏反位患者接受了肝移植；随访7个月至5年时，所有患者均存活。2例患者在最初3周内需要再次移植（分别因原发性无功能和血栓性梗死）。7例患者伴有多脾-胆道闭锁综合征相关的其他异常。这些患者的肝移植涉及选择相对较小的供体器官或使用减体积移植物。2例患者需要延迟关闭腹壁，所有患者都需要对肝上下腔静脉吻合的“背驮式”技术进行改良，以克服受者静脉异常。采用Roux-en-Y胆总管空肠吻合术进行胆道引流是首选技术。虽然在技术上具有挑战性，但内脏反位并非肝移植的禁忌证，患者有望完全康复。
