イワモト　タカユキ   Takayuki Iwamoto   岩本　高行    所属   川崎医科大学  医学部 臨床医学　乳腺甲状腺外科学    職種   講師
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	The outcome of living donor liver transplantation with prior spontaneous large portasystemic shunts.
掲載誌名	正式名：Transplant international : official journal of the European Society for Organ Transplantation 略　 称：Transpl Int ISSNコード：09340874/09340874
掲載区分	国外
巻・号・頁	21(2),pp.156-62
著者・共著者	Hiroshi Sadamori, Takahito Yagi, Hiroyoshi Matsukawa, Hiroaki Matsuda, Susumu Shinoura, Yuzo Umeda, Takayuki Iwamoto, Daisuke Satoh, Noriaki Tanaka
発行年月	2008/02
概要	We investigated the outcome of living donor liver transplantation (LDLT) with prior spontaneous large portasystemic shunts. Thirty-three patients of 155 patients (21.2%) undergoing LDLT had spontaneous large portasystemic shunts. Portal venous hemodynamics, surgical procedures for shunts, and morbidity and mortality rates were investigated in three types of shunts: splenorenal shunt (SRS group; n = 11), shunt derived from coronary vein (CVS group; n = 6) and umbilical vein shunt (UVS group; n = 15). The two groups of patients (SRS/CVS) received prophylactic surgical repair of shunts during LDLT except for one patient in the SRS group. The flow direction of main portal vein and grade of steal of superior mesenteric vein flow by shunt were significantly different among three groups. No significant differences were observed among three groups in operative parameters, hospitalization and morbidity except for postoperative portal complication. There was no significant difference in the actuarial survival rate among three groups of SRS, CVS and UVS (81.8% vs. 83.3% vs. 86.6% at 1 year respectively). In the SRS group, two patients had postoperative steal of graft portal venous flow by residual SRS that needed further treatment. The outcome of LDLT with prior spontaneous large portasystemic shunts is satisfactory, despite the complexity of the transplant procedures.
DOI	10.1111/j.1432-2277.2007.00593.x
PMID	18005086