Lessons Learned from Inappropriate Ligation of the Left Renal Vein for a Large Splenorenal Shunt in Living Donor Liver Transplantation.
10.4285/jkstn.2017.31.2.82
- Author:
Young Seok HAN
1
Author Information
1. Department of Surgery, Kyungpook National University School of Medicine, Daegu, Korea. gshys@knu.ac.kr
- Publication Type:Case Report
- Keywords:
Large splenorenal shunt;
Left renal vein ligation;
Renal vein thrombosis
- MeSH:
Constriction, Pathologic;
Hemodynamics;
Humans;
Ligation*;
Liver Transplantation*;
Liver*;
Living Donors*;
Portal Vein;
Renal Veins*;
Splenectomy;
Splenorenal Shunt, Surgical*;
Thrombosis
- From:The Journal of the Korean Society for Transplantation
2017;31(2):82-86
- CountryRepublic of Korea
- Language:English
-
Abstract:
During living donor liver transplantation, a large spontaneous splenorenal shunt (SRS) should be addressed to obtain adequate portal inflow. Various procedures such as direct ligation of the SRS, splenectomy, left renal vein ligation (LRVL), and renoportal anastomosis can be applied to treat a large SRS according to the hemodynamics of the portal flow and anatomic conditions. Of these surgical procedures, LRVL is a simple and effective solution for treatment of a large SRS. However, to perform a LRVL, rigorous evaluation of the recipient's anatomic and hemodynamic variations is mandatory. In the present case, we ligated the left renal vein to treat a large SRS, which resulted in an unexpected thrombosis of the left renal vein and remaining portal vein stenosis in the SRS. Therefore, we revised our decisions regarding whether the LRVL was properly applied.
