Portal perfusion with right gastroepiploic vein flow in liver transplant

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• 作者：Federico Mendoza-Sá ; nchez^a ; Francisco Javier-Haro^b ; Diego Federico Mendoza-Medina^c ; Alejandro Gonzá ; lez-Ojeda^c ; José ; Antonio Corté ; s-Lares^c ; Clotilde Fuentes-Orozco^c ; ^{clotilde.fuentes@gmail.com}
• 关键词：Cavernous transformation ; Portal vein ; Thrombosis ; Liver cirrhosis ; Liver transplantation
• 刊名：Cirugía y Cirujanos (English Edition)
• 出版年：2017
• 出版时间：January-February 2017
• 年：2017
• 卷：85
• 期：1
• 页码：60-65
• 全文大小：1034 K
• 卷排序：85

文摘

Liver transplantation in patients with liver cirrhosis, portal vein thrombosis, and cavernous transformation of the portal vein, is a complex procedure with high possibility of liver graft dysfunction. It is performed in 2–19% of all liver transplants, and has a significantly high mortality rate in the post-operative period. Other procedures to maintain portal perfusion have been described, however there are no reports of liver graft perfusion using right gastroepiploic vein.Clinical caseA 20-year-old female diagnosed with cryptogenic cirrhosis, with a Child-Pugh score of 7 points (class “B”), and MELD score of 14 points, with thrombosis and cavernous transformation of the portal vein, severe portal hypertension, splenomegaly, a history of upper gastrointestinal bleeding due to oesophageal varices, and left renal agenesis. The preoperative evaluation for liver transplantation was completed, and the right gastroepiploic vein of 1-cm diameter was observed draining to the infrahepatic inferior vena cava and right suprarenal vein. An orthotopic liver transplantation was performed from a non-living donor (deceased on January 30, 2005) using the Piggy-Back technique. Portal vein perfusion was maintained using the right gastroepiploic vein, and the outcome was satisfactory. The patient was discharged 13 days after surgery.ConclusionsLiver transplantation was performed satisfactorily, obtaining an acceptable outcome. In this case, the portal perfusion had adequate blood flow through the right gastroepiploic vein.