This article was presented at the 16th Annual International Congress of the International Liver Transplantation Society (Hong Kong, 2010).
Hemodynamic consequences of spontaneous splenorenal shunts in deceased donor liver transplantation†
Article first published online: 22 JUL 2011
Copyright © 2011 American Association for the Study of Liver Diseases
Volume 17, Issue 8, pages 891–895, August 2011
How to Cite
Castillo-Suescun, F., Oniscu, G. C. and Hidalgo, E. (2011), Hemodynamic consequences of spontaneous splenorenal shunts in deceased donor liver transplantation. Liver Transpl, 17: 891–895. doi: 10.1002/lt.22304
- Issue published online: 22 JUL 2011
- Article first published online: 22 JUL 2011
- Accepted manuscript online: 21 MAR 2011 12:21PM EST
- Manuscript Accepted: 5 MAR 2011
- Manuscript Received: 18 AUG 2010
The presence of large spontaneous splenorenal shunts (SSRSs) is a risk factor for poor portal vein flow and liver dysfunction. The disconnection of splenorenal shunts by left renal vein (LRV) ligation has been suggested as a potential solution for improving portal flow. We reviewed the hemodynamic consequences of splenorenal shunts in deceased donor liver transplantation and investigated the role of LRV ligation. In 10 patients who underwent liver transplantation at our institution between January 2006 and April 2010, an SSRS was diagnosed preoperatively. Intraoperative portal and hepatic artery flows were measured with a transit time flowmeter. The shunt was disconnected in 6 patients for whom the portal flow after reperfusion was less than or equal to 1200 mL/minute. LRV ligation resulted in significant increases in the portal flow. There were no differences in renal function for the patients who underwent renal vein ligation and the patients who did not undergo ligation. In conclusion, LRV ligation disconnects splenorenal shunts and modulates the portal inflow without any detrimental effects on renal function. Liver Transpl 17:891–895, 2011. © 2011 AASLD.