Endovascular closure of a hemiportocaval shunt after small-for-size adult-to-adult left lobe living donor liver transplantation

Jean F. Botha, B. Daniel Campos, Jason Johanning, David Mercer, Wendy Grant, Alan Langnas

Research output: Contribution to journalArticle

24 Scopus citations

Abstract

Adult-to-adult living donor liver transplantation is an accepted treatment option for patients with end-stage liver disease. It is generally acknowledged that a graft weight to recipient body weight ratio > 0.8 is required in order to prevent the development of small-for-size syndrome. Size mismatch, however, is not the only factor responsible for the syndrome; instead, it results from a combination of factors, including the size, recipient status, and degree of portal hypertension. The ability to modulate the portal venous inflow has sparked renewed interest in the left lobe graft. We have used the hemiportocaval shunt, as described by Troisi et al. (Am J Transplant 2005;5:1397-1404), in left lobe living donor liver transplants in order to prevent small-for-size syndrome while enhancing the safety of the donor operation. In this report, we describe a novel technique for occluding a hemiportocaval shunt in a patient who developed hepatic encephalopathy after receiving a small-for-size left lobe liver allograft from a living donor.

Original languageEnglish (US)
Pages (from-to)1671-1675
Number of pages5
JournalLiver Transplantation
Volume15
Issue number12
DOIs
StatePublished - Dec 2009

ASJC Scopus subject areas

  • Surgery
  • Hepatology
  • Transplantation

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