Liver transplantation in patients with a surgical portasystemic shunt.
Gastroenterol Clin Biol
; 15(12): 876-80, 1991.
Article
em En
| MEDLINE
| ID: mdl-1783246
ABSTRACT
Of 220 patients undergoing liver transplantation between March 1982 and April 1991, eighteen (8.1 percent) already had a surgical portasystemic shunt. Four patients had a distal splenorenal shunt, six a side-to-side portacaval shunt, three an end-to-side portacaval shunt, and five, a mesocaval shunt. The splanchnic venous system was assessed by Doppler ultrasound examination and angiography before liver transplantation. Perioperative mortality rate was higher but not significantly different from that observed in the population of patients without previous portasystemic shunt (33.3 percent versus 21.7 percent). Liver transplantation was particularly difficult in the six patients with a previous side-to-side portacaval shunt, in which the perioperative mortality rate was high (66.6 percent). Liver transplantation is feasible in patients with a previous portasystemic shunt but carries a higher risk. It is easier when no previous dissection of the hepatic pedicle has been done. Suppression of the shunt after revascularization of the graft must be performed in order to provide optimal venous flow to the hepatic graft.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Veia Porta
/
Tromboflebite
/
Derivação Portossistêmica Cirúrgica
/
Transplante de Fígado
Tipo de estudo:
Etiology_studies
Limite:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Gastroenterol Clin Biol
Ano de publicação:
1991
Tipo de documento:
Article