Temporary Portocaval Shunt by Piggyback Cava in Liver Re-Transplantation: Report of a Case
Journal Title: Journal of Advances in Medicine and Medical Research - Year 2014, Vol 4, Issue 3
Abstract
Re-transplantation operation is a technically difficult procedure because of many adhesions; it has higher morbidity and mortality. In this article a maneuver facilitating liver re-transplantation is described. 27-year old male with hepatic artery thrombosis three months after the deceased liver transplantation admitted to our clinic for re-transplantation. Related living right lobe liver transplantation was planned. During recipient’s hepatectomy, the hepatic hilum was transected first, but retroperitoneal dissection and identification of the patient’s vena cava was very difficult. Prolonged operative time and risk of mesenteric venous hypertension after the clamping of portal vein required an application of temporary porto-caval bypass. For this shunt the portal vein of recipient and lower end of cadaveric liver vena cava (“piggyback vena cava”) were used. Vena cava of patient was not clamped during the bypass application, so blood flow in patient’s inferior vena cava was not deteriorated. The liver was removed with both caval veins (cadaveric liver vein and recipient’s own vein) remained in patient’s body. Living donor graft was connected to the piggyback vena cava. Temporary shunt was divided and portal vein anastomosed to the graft portal vein. Arterial anastomosis was performed with recipient’s gastroepiploic artery and the biliary reconstruction fashioned by Roux-en-Y hepaticojejunostomy. So, piggyback vena cava can be used successfully and safely for temporary porto-caval shunt during the liver re-transplantation.
Authors and Affiliations
Ruslan Mamedov, Bulent Unal, Cengız Ara, Cemalettın Aydın, Fahri Yetisir, Nuru Bayramov, Guneyt Kayaalp, Sezai Yilmaz
Keywords
Related Articles
- EP ID EP348771
- DOI 10.9734/BJMMR/2014/5694
- Views 75
- Downloads 0
No More Live Lectures - Quixotism or Realism-? Association between Learning Preferences and Attendances at Live Lectures
Background: The increasing decline in medical students’ attendances at live lectures left educators with differing views on its acceptability. Aim: The aim of this study was to look at the association between the medica...
Reversible Cerebral Vasoconstriction Syndrome – A Systematic Approach
Aims: Reversible cerebral vasoconstriction syndrome (RCVS) is a rare idiopathic clinical syndrome presenting as reversible multifocal segmental vasoconstriction of cerebral arteries, typically affecting middle aged women...
Increasing Radiation Doses from Computed Tomography versus Diagnostic Reference Levels: How Compliance Are We?
Aim: To assess the radiation dose received in a clinical/real life setting by patients visiting selected radiological centres in Enugu, Enugu State, southeast of Nigeria for diagnostic computed tomography (CT) scan...
Identification of Candidate Biomarkers and Cancer Genes AHNAK2 and EPPK1 in Pancreatic Cancer
Aims: The lack of specific symptoms at early tumor stages, together with a high biological aggressiveness of the tumor contribute to the high mortality rate for pancreatic cancer (PC). Improved screening for earlier diag...
Breast Cancer in Muslim Countries: Risk Reduction Strategies
Breast cancer is the most common cancer in women in western countries and is becoming significant in many developing countries. It is the most common cancer and the primary cause of cancer-related mortality in women in M...