Takayuki Iwamoto
   Department   Kawasaki Medical School  Kawasaki Medical School, Department of Breast and Thyroid Surgery,
   Position   Assistant Professor
Article types 原著
Language English
Peer review Peer reviewed
Title The outcome of living donor liver transplantation with prior spontaneous large portasystemic shunts.
Journal Formal name：Transplant international : official journal of the European Society for Organ Transplantation
Abbreviation：Transpl Int
ISSN code：09340874/09340874
Domestic / ForeginForegin
Volume, Issue, Page 21(2),pp.156-62
Author and coauthor Hiroshi Sadamori, Takahito Yagi, Hiroyoshi Matsukawa, Hiroaki Matsuda, Susumu Shinoura, Yuzo Umeda, Takayuki Iwamoto, Daisuke Satoh, Noriaki Tanaka
Publication date 2008/02
Summary 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