A case report of pediatric liver transplantation complicated with median arcuate ligament compression syndrome
10.3760/cma.j.cn421203-20231011-00126
- VernacularTitle:儿童肝移植合并正中弓状韧带压迫综合征1例
- Author:
Ying LE
1
;
Mingman ZHANG
1
;
Yingcun LI
1
;
Xiaoke DAI
1
Author Information
1. 重庆医科大学附属儿童医院肝胆外科 儿童发育疾病研究教育部重点实验室 儿童发育重大疾病国家国际科技合作基地 儿科学重庆市重点实验室，重庆 400014
- Publication Type:Journal Article
- Keywords:
Liver transplantation;
Median arcuate ligament;
Hepatic artery thrombosis;
Computed tomography angiography
- From:
Chinese Journal of Organ Transplantation
2025;46(3):235-238
- CountryChina
- Language:Chinese
-
Abstract:
Median arcuate ligament compression syndrome (MALS) presents with atypical clinical manifestations. MALS is rarely reported in pediatric patients but is recognized as an independent risk factor for postoperative hepatic artery thrombosis in liver transplant recipients. We report a case of a pediatric liver transplant recipient with hepatolenticular degeneration, cirrhosis, and acute liver failure. Despite undergoing artificial liver support therapy, the patient showed no significant improvement in liver function and subsequently underwent liver transplantation. Intraoperatively, weak arterial pulsation and the absence of a pulsatile waveform in the hepatic artery anastomosis raised suspicion of MALS. The condition was successfully managed by releasing and transecting the median arcuate ligament, along with ligation of the splenic and left gastric arteries. To optimize transplantation outcomes, meticulous preoperative imaging assessment, particularly focusing on characteristic findings in CT angiography, is essential. Additionally, individualized surgical planning and intraoperative adjustments based on ultrasound monitoring and arterial pulsation assessments are critical for ensuring successful transplantation.
