Two-Stage Liver Transplantation with Temporary Porto-Middle Hepatic Vein Shunt
Two-stage liver transplantation (LT) has been reported for cases of fulminant liver failure that can lead to toxic hepatic syndrome, or massive hemorrhages resulting in uncontrollable bleeding. Technically, the first stage of the procedure consists of a total hepatectomy with preservation of the rec...
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| Format: | Article |
| Language: | English |
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Wiley
2010-01-01
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| Series: | Journal of Transplantation |
| Online Access: | http://dx.doi.org/10.1155/2010/570392 |
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| author | Giovanni Varotti Enzo Andorno Marco Casaccia Stefano Di Domenico Giuliano Bottino Pietro Diviacco Nicola Morelli Chiara Ferrari Roberto Ferrante Umberto Valente |
| author_facet | Giovanni Varotti Enzo Andorno Marco Casaccia Stefano Di Domenico Giuliano Bottino Pietro Diviacco Nicola Morelli Chiara Ferrari Roberto Ferrante Umberto Valente |
| author_sort | Giovanni Varotti |
| collection | DOAJ |
| description | Two-stage liver transplantation (LT) has been reported for cases of fulminant liver failure that can lead to toxic hepatic syndrome, or massive hemorrhages resulting in uncontrollable bleeding. Technically, the first stage of the procedure consists of a total hepatectomy with preservation of the recipient's inferior vena cava (IVC), followed by the creation of a temporary end-to-side porto-caval shunt (TPCS). The second stage consists of removing the TPCS and implanting a liver graft when one becomes available. We report a case of a two-stage total hepatectomy and LT in which a temporary end-to-end anastomosis between the portal vein and the middle hepatic vein (TPMHV) was performed as an alternative to the classic end-to-end TPCS. The creation of a TPMHV proved technically feasible and showed some advantages compared to the standard TPCS. In cases in which a two-stage LT with side-to-side caval reconstruction is utilized, TPMHV can be considered as a safe and effective alternative to standard TPCS. |
| format | Article |
| id | doaj-art-0ce871ecb02f4c11bce3d206c610e2e7 |
| institution | OA Journals |
| issn | 2090-0007 2090-0015 |
| language | English |
| publishDate | 2010-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Transplantation |
| spelling | doaj-art-0ce871ecb02f4c11bce3d206c610e2e72025-08-20T02:03:01ZengWileyJournal of Transplantation2090-00072090-00152010-01-01201010.1155/2010/570392570392Two-Stage Liver Transplantation with Temporary Porto-Middle Hepatic Vein ShuntGiovanni Varotti0Enzo Andorno1Marco Casaccia2Stefano Di Domenico3Giuliano Bottino4Pietro Diviacco5Nicola Morelli6Chiara Ferrari7Roberto Ferrante8Umberto Valente9Department of Surgery and Transplantation, San Martino Hospital, University of Genoa, Monoblocco IV, Largo R. Benzi 10, 16132 Genoa, ItalyDepartment of Surgery and Transplantation, San Martino Hospital, University of Genoa, Monoblocco IV, Largo R. Benzi 10, 16132 Genoa, ItalyDepartment of Surgery and Transplantation, San Martino Hospital, University of Genoa, Monoblocco IV, Largo R. Benzi 10, 16132 Genoa, ItalyDepartment of Surgery and Transplantation, San Martino Hospital, University of Genoa, Monoblocco IV, Largo R. Benzi 10, 16132 Genoa, ItalyDepartment of Surgery and Transplantation, San Martino Hospital, University of Genoa, Monoblocco IV, Largo R. Benzi 10, 16132 Genoa, ItalyDepartment of Surgery and Transplantation, San Martino Hospital, University of Genoa, Monoblocco IV, Largo R. Benzi 10, 16132 Genoa, ItalyDepartment of Surgery and Transplantation, San Martino Hospital, University of Genoa, Monoblocco IV, Largo R. Benzi 10, 16132 Genoa, ItalyDepartment of Surgery and Transplantation, San Martino Hospital, University of Genoa, Monoblocco IV, Largo R. Benzi 10, 16132 Genoa, ItalyDepartment of Surgery and Transplantation, San Martino Hospital, University of Genoa, Monoblocco IV, Largo R. Benzi 10, 16132 Genoa, ItalyDepartment of Surgery and Transplantation, San Martino Hospital, University of Genoa, Monoblocco IV, Largo R. Benzi 10, 16132 Genoa, ItalyTwo-stage liver transplantation (LT) has been reported for cases of fulminant liver failure that can lead to toxic hepatic syndrome, or massive hemorrhages resulting in uncontrollable bleeding. Technically, the first stage of the procedure consists of a total hepatectomy with preservation of the recipient's inferior vena cava (IVC), followed by the creation of a temporary end-to-side porto-caval shunt (TPCS). The second stage consists of removing the TPCS and implanting a liver graft when one becomes available. We report a case of a two-stage total hepatectomy and LT in which a temporary end-to-end anastomosis between the portal vein and the middle hepatic vein (TPMHV) was performed as an alternative to the classic end-to-end TPCS. The creation of a TPMHV proved technically feasible and showed some advantages compared to the standard TPCS. In cases in which a two-stage LT with side-to-side caval reconstruction is utilized, TPMHV can be considered as a safe and effective alternative to standard TPCS.http://dx.doi.org/10.1155/2010/570392 |
| spellingShingle | Giovanni Varotti Enzo Andorno Marco Casaccia Stefano Di Domenico Giuliano Bottino Pietro Diviacco Nicola Morelli Chiara Ferrari Roberto Ferrante Umberto Valente Two-Stage Liver Transplantation with Temporary Porto-Middle Hepatic Vein Shunt Journal of Transplantation |
| title | Two-Stage Liver Transplantation with Temporary Porto-Middle Hepatic Vein Shunt |
| title_full | Two-Stage Liver Transplantation with Temporary Porto-Middle Hepatic Vein Shunt |
| title_fullStr | Two-Stage Liver Transplantation with Temporary Porto-Middle Hepatic Vein Shunt |
| title_full_unstemmed | Two-Stage Liver Transplantation with Temporary Porto-Middle Hepatic Vein Shunt |
| title_short | Two-Stage Liver Transplantation with Temporary Porto-Middle Hepatic Vein Shunt |
| title_sort | two stage liver transplantation with temporary porto middle hepatic vein shunt |
| url | http://dx.doi.org/10.1155/2010/570392 |
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