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[Portal perfusion with right gastroepiploic vein flow in liver transplant].
- Source :
-
Cirugia y cirujanos [Cir Cir] 2017 Jan - Feb; Vol. 85 (1), pp. 60-65. Date of Electronic Publication: 2016 Jan 05. - Publication Year :
- 2017
-
Abstract
- Background: 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.<br />Clinical Case: A 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.<br />Conclusions: Liver transplantation was performed satisfactorily, obtaining an acceptable outcome. In this case, the portal perfusion had adequate blood flow through the right gastroepiploic vein.<br /> (Copyright © 2015 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.)
- Subjects :
- Abnormalities, Multiple
Blood Flow Velocity
Computed Tomography Angiography
Esophageal and Gastric Varices etiology
Esophageal and Gastric Varices surgery
Female
Gastrointestinal Hemorrhage etiology
Humans
Hypertension, Portal complications
Hypertension, Portal surgery
Liver Cirrhosis complications
Liver Cirrhosis surgery
Portal System diagnostic imaging
Portal Vein abnormalities
Portal Vein diagnostic imaging
Portal Vein surgery
Postoperative Complications etiology
Splenomegaly complications
Veins diagnostic imaging
Veins surgery
Vena Cava, Inferior
Venous Thrombosis complications
Young Adult
Liver Circulation
Liver Transplantation methods
Portal System surgery
Subjects
Details
- Language :
- Spanish; Castilian
- ISSN :
- 2444-054X
- Volume :
- 85
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Cirugia y cirujanos
- Publication Type :
- Academic Journal
- Accession number :
- 26769523
- Full Text :
- https://doi.org/10.1016/j.circir.2015.08.010