The authors declare that they do not have proprietary, financial, professional, or other personal interest of any nature or kind in any product, service, and/or company that could be construed as influencing the position presented in this article.
Technical aspects and outcomes of living donor liver transplantation for pediatric patients with situs inversus
Article first published online: 22 MAR 2013
Copyright © 2013 American Association for the Study of Liver Diseases
Volume 19, Issue 4, pages 431–436, April 2013
How to Cite
Vincenzi, R., Seda-Neto, J., Fonseca, E. A. d., Ketzer, B. M., Benavides, M., Cândido, H. L., Porta, G., Miura, I. K., Pugliese, R., Danesi, V. B., Guimaraes, T. C., Porta, A., Borges, C. B., Kondo, M. and Chapchap, P. (2013), Technical aspects and outcomes of living donor liver transplantation for pediatric patients with situs inversus. Liver Transpl, 19: 431–436. doi: 10.1002/lt.23611
- Issue published online: 27 MAR 2013
- Article first published online: 22 MAR 2013
- Accepted manuscript online: 27 FEB 2013 03:08PM EST
- Manuscript Accepted: 23 DEC 2012
- Manuscript Received: 1 OCT 2012
The vascular anomalies encountered in patients with biliary atresia associated with polysplenia syndrome and situs inversus (SI) demand technical refinements when liver transplantation is being performed. The available data describing the technique used in living donor liver transplantation (LDLT) in this population are limited; the short vascular stumps of the donor's liver can impart additional technical difficulties during vascular reconstruction. Here we describe our experience with 9 children with biliary atresia and SI who underwent LDLT. In our series, the retrohepatic vena cava was absent for 7 patients, 7 had a preduodenal portal vein (PV), and 4 had a variant arterial anatomy. The donor's left hepatic vein was anastomosed to the confluence of the recipient's 3 hepatic veins in 7 patients. Vascular grafts were used for PV reconstruction in 3 cases. A left lateral segment graft was used in all but 1 patient who needed a graft reduction. All grafts were placed in the upper left abdomen. There were no vascular complications after transplantation. All patients were alive and well at a median follow-up of 55 months. In conclusion, LDLT can be successfully performed in pediatric patients with SI. Complex vascular anomalies associated with the use of partial liver grafts obtained from living donors are not associated with an increased occurrence of vascular complications. Liver Transpl 19:431–436, 2013. © 2013 AASLD.