Individualized treatment of splenorenal shunt during liver transplantation

Cheng Daorou; Yang Qing; Zhang Yingcai; Wang Li; Chen Xiaolong; Li Hui; Yang Yang; Chen Guihua; Wang Genshu

doi:10.3969/j.issn.1674-7445.2019.04.016

Volume 10 Issue 4

Jul. 2019

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Cheng Daorou, Yang Qing, Zhang Yingcai, et al. Individualized treatment of splenorenal shunt during liver transplantation[J]. ORGAN TRANSPLANTATION, 2019, 10(4): 443-448. doi: 10.3969/j.issn.1674-7445.2019.04.016

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Individualized treatment of splenorenal shunt during liver transplantation

doi: 10.3969/j.issn.1674-7445.2019.04.016

Department of Hepatic Surgery, Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University, Key Laboratory of Liver Disease Research of Guangdong Province, Guangzhou 510630, China

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Corresponding author: Wang Genshu, Email:wgsh168@163.com
Received Date: 2019-05-17
Available Online: 2021-01-19
Publish Date: 2019-07-15

Abstract

Abstract

Objective To evaluate the safety and efficacy of individualized treatment of splenorenal shunt during liver transplantation. Methods Clinical data of 2 recipients who underwent orthotopic liver transplantation and splenorenal shunt intraoperatively were retrospectively analyzed. According to the perfusion status after splenorenal shunt and donor liver reflow, the left renal vein ligation and splenorenal shunt vessel ligation were performed in two recipients during liver transplantation. The general postoperative conditions of the recipients were observed, including surgical related complications, peak portal blood flow velocity, liver and renal function indexs. The postoperative conditions of the recipients were monitored by abdominal ultrasound. Results No intraoperative or postoperative complications occurred in two recipients. The changes of peak portal blood flow velocity before and after splenorenal shunt in two recipients were 22.9-35.1 cm/s and 24.3-58.8 cm/s respectively. No delayed recovery of alanine aminotransferase (ALT) level was observed in two patients after operation. Case 1 experienced a transient increase in the serum creatinine (Scr), which was recovered to normal at postoperative 13 d. During the postoperative follow-up, ultrasound examination demonstrated that the direction and velocity of portal blood flow were normal and liver perfusion was excellent. Conclusions It is safe and effective to selectively ligate the left renal vein or splenorenal shunt vessels of the recipients with severe splenorenal shunt during liver transplantation.
- Splenorenal shunt,
- Liver transplantation,
- Left renal vein ligation,
- Splenorenal shunt vessel ligation,
- Individualized treatment

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Individualized treatment of splenorenal shunt during liver transplantation

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