medigraphic.com
Órgano Oficial de la Asociación Mexicana de Hepatología

2006, Number 1

<< Back Next >>

Ann Hepatol 2006; 5 (1)

Orthotopic liver transplantation in an adult with situs inversus: an easy way to fit the liver

Sergio Hoyos, Carlos Guzmán, Gonzalo Correa, Juan Carlos Restrepo, Hernán Franco, Andrés Cárdenas

Language: English
References: 18
Page: 53-55
PDF size: 120.86 Kb.


Text Extraction

Situs inversus (SI) is a rare congenital disorder with a complete mirror image of thoracic and abdominal organs. In adults with SI and decompensated cirrhosis experience with liver transplantation is limited. Orthotopic liver transplantation (OLT) in an adult with cirrhosis using a technique where the recipient liver was placed using a 90-degree rotation of the graft was previously reported by Klintmalm et al, however no other reports using this technique have been described. We report a case of a 41 year-old man with situs inversus and decompensated cirrhosis who successfully underwent OLT using this technique. The donor liver was rotated 90-degrees towards the left and easily fitted into the recipients’ fossa with the left lobe pointing toward the left lower quadrant. The patient had an uneventful recovery and has been followed for 21 months without any complications. This technique has the advantage of preventing compromise of the size of the donor liver, permits an easy reconstruction of vascular and biliary tree and in this case was associated with an excellent outcome.


REFERENCES

  1. Casey B. Two rights make a wrong: human left-right malformations. Hum Mol Genet 1998; 7(10): 1565.

  2. Kosaki K, Casey B. Genetics of human left-right axis malformations. Semin Cell Biol 1998; 9: 89.

  3. Karrer FM, Hall RJ, Lilly JR. Biliary atresia and the polysplenia syndrome. J Pediatr Surg 1991; 26: 524.

  4. Heimbach JK, Menon KV, Ishitani MB, Nyberg SL, Jankowski CJ, Lindor KD, Rosen CB. Living donor liver transplantation using a right lobe graft in an adult with situs inversus. Liver Transpl 2005; 11: 111.

  5. Sugawara Y, Makuuchi M, Takayama T, Yoshino H, Mizuta K, Kawarasaki H. Liver transplantation from situs inversus to situs inversus. Liver Transpl 2001; 7: 829.

  6. Todo S, Hall R, Tzakis A, Starzl TE. Liver transplantation in patients with situs inversus. Clin Transplant 1990; 4: 5.

  7. Kamei H, Kasahara M, Uryuhara K, Kozaki K, Ogawa K, Ogura Y, Fujimoto Y, Takada Y, Tanaka K. Living-donor liver transplantation for situs inversus: 2 case reports. J Pediatr Surg 2005; 40: E35.

  8. Mattei P, Wise B, Schwarz K, Klein A, Colombani PM. Orthotopic liver transplantation in patients with biliary atresia and situs inversus. Pediatr Surg Int 1998; 14: 104.

  9. Braun F, Rodeck B, Lorf T, Canelo R, Wietzke P, Hartmann H, et al. Situs inversus of donor or recipient in liver transplantation. Transpl Int 1998; 11: 212.

  10. Kawamoto S, Strong RW, Lynch SV, Ong TH, Pillay SP, Yamanaka J, Balderson GA. Liver transplantation in the presence of situs inversus totalis: application of reduced-size graft. Liver Transpl Surg 1995; 1: 23.

  11. Maggard MA, Goss JA, Swenson KL, McDiarmid SV, Busuttil RW. Liver transplantation in polysplenia syndrome: use of a living-related donor. Transplantation 1999; 68: 1206.

  12. Colomb K, Mizrahi S, Downes T, Hayes DH, Hussey JL, Boudreaux JP. Liver transplantation in patients with situs inversus. Transpl Int 1993; 6: 158.

  13. Barone GW, Henry ML, Elkhammas EA, Tesi RJ, Ferguson RM. Orthotopic liver transplantation with abdominal situs inversus and dextrocardia. Am Surg 1992; 58: 651.

  14. Raynor SC, Wood RP, Spanta AD, Shaw BW Jr. Liver transplantation in a patient with abdominal situs inversus. Transplantation 1988; 45: 661.

  15. Farmer DG, Shaked A, Olthoff KM, Imagawa DK, Millis JM, Busuttil RW. Evaluation, operative management, and outcome after liver transplantation in children with biliary atresia and situs inversus. Ann Surg 1995; 222: 47.

  16. Watson CJ, Rasmussen A, Jamieson NV, Friend PJ, Johnston PS, Barnes ND, Calne RY. Liver transplantation in patients with situs inversus. Br J Surg 1995; 82: 242.

  17. Klintmalm GB, Bell MS, Husberg BS, Holman MJ, Goldstein RM, Ramsay MA, Polter DE. Liver transplant in complete situs inversus: a case report. Surgery 1993; 114: 102.

  18. Eghtesad B, Kadry Z, Fung J. Technical considerations in liver transplantation: What a hepatologist needs to know (and every surgeon should practice). Liver Transpl 2005; 11: 861.




2020     |     www.medigraphic.com