Authors:
Balázs Nemes Department of Transplantation and Surgery, Semmelweis University, Baross u. 23–25, H-1082, Budapest, Hungary

Search for other papers by Balázs Nemes in
Current site
Google Scholar
PubMed
Close
,
D. Görög Department of Transplantation and Surgery, Semmelweis University, Baross u. 23–25, H-1082, Budapest, Hungary

Search for other papers by D. Görög in
Current site
Google Scholar
PubMed
Close
,
I. Fehérvári Department of Transplantation and Surgery, Semmelweis University, Baross u. 23–25, H-1082, Budapest, Hungary

Search for other papers by I. Fehérvári in
Current site
Google Scholar
PubMed
Close
,
T. Mándli Department of Transplantation and Surgery, Semmelweis University, Baross u. 23–25, H-1082, Budapest, Hungary

Search for other papers by T. Mándli in
Current site
Google Scholar
PubMed
Close
,
E. Sárváry Department of Transplantation and Surgery, Semmelweis University, Baross u. 23–25, H-1082, Budapest, Hungary

Search for other papers by E. Sárváry in
Current site
Google Scholar
PubMed
Close
,
L. Kóbori Department of Transplantation and Surgery, Semmelweis University, Baross u. 23–25, H-1082, Budapest, Hungary

Search for other papers by L. Kóbori in
Current site
Google Scholar
PubMed
Close
,
A. Doros Department of Transplantation and Surgery, Semmelweis University, Baross u. 23–25, H-1082, Budapest, Hungary

Search for other papers by A. Doros in
Current site
Google Scholar
PubMed
Close
, and
J. Fazakas Department of Transplantation and Surgery, Semmelweis University, Baross u. 23–25, H-1082, Budapest, Hungary

Search for other papers by J. Fazakas in
Current site
Google Scholar
PubMed
Close
Restricted access

Abstract

Portal vein reconstruction might be a challenge in certain cases of liver transplantation. The problem usually arises due to small vessels in pediatric transplantation and/or living related donor and split liver transplantation, or as a result of extensive PVT in adult recipients. Authors report a case of a 60-year-old alcoholic cirrhotic patient with reverse portal flow. The standard end to end portal anastomosis did not work well, so a mesoportal shunt with a donor iliac vein conduit was performed first, followed by a cavoportal hemitransposition. After unsuccessful attempts of providing good portal flow, the donor umbilical vein and the iliac conduit was used for portal flow reconstruction as meso-Rex graft. The patient has been doing fine for eight months after her liver transplantation. Unusual types of portal reconstructions consist of meso-portal, umbilico-portal, renoportal anastomoses that are primarily used as rescue techniques. However, it is rare that one has to use them sequentially in the same patient.

  • 1. C. Couinaud 1993 Absence of portal bifurcation [In French] J Chir 130 111 115.

  • 2. S. Emre C. Dugan T. Frankenberg L.C. Hudgins R. Gagliardi A.T. Artis G. Rodriguez-Laiz G. Gondolesi B.L. Shneider N. Kerkar 2009 Surgical portosystemic shunts and the Rex bypass in children: A single-centre experience HPB (Oxford) 11 252 257.

    • Search Google Scholar
    • Export Citation
  • 3. J. Fuchs S. Warmann R. Kardorff H. Rosenthal B. Rodeck B. Ure M. Melter 2003 Mesenterico-left portal vein bypass in children with congenital extrahepatic portal vein thrombosis: A unique curative approach J Pediatr Gastroenterol Nutr 36 213 216.

    • Search Google Scholar
    • Export Citation
  • 4. N.E. Gibelli U. Tannuri M.L. de Pinho-Apezzato A.C. Tannuri J.G. Maksoud-Filho M.C. Velhote M.M. Santos A.A. Ayoub M. Marques da Silva W.C. Andrade 2009 Rex shunt” for the treatment of portal vein thrombosis after pediatric liver transplantation: A case report Transplant Proc 41 955 956.

    • Search Google Scholar
    • Export Citation
  • 5. D. Krebs-Schmitt A. Briem-Richter E. Grabhorn M. Burdelski K. Helmke D.C. Broering R. Ganschow 2009 Effectiveness of Rex shunt in children with portal hypertension following liver transplantation or with primary portal hypertension Pediatr Transplant 13 540 544.

    • Search Google Scholar
    • Export Citation
  • 6. O. Ateş G. Hakgüder M. Olguner M. Seçil I. Karaca F.M. Akgür 2006 Mesenterico left portal bypass for variceal bleeding owing to extrahepatic portal hypertension caused by portal vein thrombosis J Pediatr Surg 41 1259 1263.

    • Search Google Scholar
    • Export Citation
  • 7. D. Nikitin L.W. Jennings T. Khan S. Vasani R. Ruiz E.Q. Sanchez S. Chinnakotla M.F. Levy R.M. Goldstein G.B. Klintmalm 2009 Twenty years' follow-up of portal vein conduits in liver transplantation Liver Transpl 15 400 406.

    • Search Google Scholar
    • Export Citation
  • 8. S. Bonnet A. Sauvanet O. Bruno D. Sommacale C. Francoz F. Dondero F. Durand J. Belghiti 2010 Long-term survival after portal vein arterialization for portal vein thrombosis in orthotopic liver transplantation Gastroenterol Clin Biol 34 23 28.

    • Search Google Scholar
    • Export Citation
  • 9. T.H. Wu H.S. Chou K.T. Pan C.S. Lee T.J. Wu S.Y. Chu M.F. Chen W.C. Lee 2009 Application of cryopreserved vein grafts as a conduit between the coronary vein and liver graft to reconstruct portal flow in adult living liver transplantation Clin Transplant 23 751 755.

    • Search Google Scholar
    • Export Citation
  • 10. M. Paskonis J. Jurgaitis A. Mehrabi A. Kashfi H. Fonouni K. Strupas M.W. Büchler T.W. Kraus 2006 Surgical strategies for liver transplantation in the case of portal vein thrombosis — Current role of cavoportal hemitransposition and renoportal anastomosis Clin Transplant 20 551 562.

    • Search Google Scholar
    • Export Citation
  • 11. K. Hashimoto M. Shimada T. Suehiro Y. Soejima R. Minagawa S. Hiroshige S. Shiotani M. Ninomiya N. Harada K. Komori K. Sugimachi 2003 Gore-Tex jump graft for portal vein thrombosis following living donor liver transplantation Hepatogastroenterology 50 1146 1148.

    • Search Google Scholar
    • Export Citation
  • 12. D. Moon S. Lee S. Hwang K. Park K. Kim C. Ahn Y. Lee T. Ha S. Cho K. Oh Y. Kim K. Kim 2004 Umbilical portion of recipient's left portal vein: a useful vascular conduit in dual living donor liver transplantation for the thrombosed portal vein Liver Transpl 10 802 806.

    • Search Google Scholar
    • Export Citation
  • 13. H. Mergental A.S. Gouw M.J. Slooff K.P. de Jong 2007 Venous outflow reconstruction with surgically reopened obliterated umbilical vein in domino liver transplantation Liver Transpl 13 769 772.

    • Search Google Scholar
    • Export Citation
  • 14. P. Gloviczki P.C. Pairolero K.J. Cherry J.W. Hallett Jr 1990 Reconstruction of the vena cava and of its primary tributaries: A preliminary report J Vasc Surg 11 373 381.

    • Search Google Scholar
    • Export Citation
  • 15. L. Kobori A. Doros T. Nemeth J. Fazakas B. Nemes M.J.H. Slooff et al.2005 The use of autologous rectus facia sheath for replacement of inferior caval vein defect in orthotopic liver transplantation Transpl Int 18 1376 1377.

    • Search Google Scholar
    • Export Citation
  • 16. Y. Toshimitsu M. Miyazawa T. Torii I. Koyama Y. Ikada 2005 Tissue-engineered patch for the reconstruction of inferior vena cava during living-donor liver transplantation J Gastrointest Surg 9 789 793.

    • Search Google Scholar
    • Export Citation
  • Collapse
  • Expand

2019  
Scimago
H-index
11
Scimago
Journal Rank
0,220
Scimago
Quartile Score
Medicine (miscellaneous) Q3
Scopus
Cite Score
155/133=1,2
Scopus
Cite Score Rank
General Medicine 199/529 (Q2)
Scopus
SNIP
0,343
Scopus
Cites
206
Scopus
Documents
23

 

Interventional Medicine and Applied Science
Language English
Size  
Year of
Foundation
2009
Publication
Programme
changed title
Volumes
per Year
 
Issues
per Year
 
Founder Akadémiai Kiadó
Founder's
Address
H-1117 Budapest, Hungary 1516 Budapest, PO Box 245.
Publisher Akadémiai Kiadó
Publisher's
Address
H-1117 Budapest, Hungary 1516 Budapest, PO Box 245.
Responsible
Publisher
Chief Executive Officer, Akadémiai Kiadó
ISSN 2061-1617 (Print)
ISSN 2061-5094 (Online)

Monthly Content Usage

Abstract Views Full Text Views PDF Downloads
Dec 2023 33 4 3
Jan 2024 56 0 1
Feb 2024 14 1 0
Mar 2024 4 1 0
Apr 2024 24 0 0
May 2024 8 0 0
Jun 2024 5 0 0