Hemodynamic consequences of spontaneous splenorenal shunts in deceased donor liver transplantation
Open Access
- 21 March 2011
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Liver Transplantation
- Vol. 17 (8), 891-895
- https://doi.org/10.1002/lt.22304
Abstract
The presence of large spontaneous splenorenal shunts (SSRSs) is a risk factor for poor portal vein flow and liver dysfunction. The disconnection of splenorenal shunts by left renal vein (LRV) ligation has been suggested as a potential solution for improving portal flow. We reviewed the hemodynamic consequences of splenorenal shunts in deceased donor liver transplantation and investigated the role of LRV ligation. In 10 patients who underwent liver transplantation at our institution between January 2006 and April 2010, an SSRS was diagnosed preoperatively. Intraoperative portal and hepatic artery flows were measured with a transit time flowmeter. The shunt was disconnected in 6 patients for whom the portal flow after reperfusion was less than or equal to 1200 mL/minute. LRV ligation resulted in significant increases in the portal flow. There were no differences in renal function for the patients who underwent renal vein ligation and the patients who did not undergo ligation. In conclusion, LRV ligation disconnects splenorenal shunts and modulates the portal inflow without any detrimental effects on renal function. Liver Transpl 17:891–895, 2011. © 2011 AASLD.Keywords
This publication has 22 references indexed in Scilit:
- Ligation of left renal vein for large spontaneous splenorenal shunt to prevent portal flow steal in adult living donor liver transplantationTransplant International, 2007
- Portal Venous Flow Pattern as a Useful Tool for Predicting Esophageal Varix Bleeding in Cirrhotic PatientsDigestive Diseases and Sciences, 2005
- Severe fatty change of the graft liver caused by a portosystemic shunt of mesenteric varicesTransplant International, 2002
- Reversible hepatofugal portal flow after liver transplantation using a small-for-size graft from a living donorTransplant International, 2001
- Liver transplantation in patients with splenorenal shunts: intraoperative flow measurements to indicate shunt occlusion.Liver Transplantation and Surgery, 1999
- INFLUENCE OF SPONTANEOUS PORTOSYSTEMIC COLLATERAL PATHWAYS ON PORTAL HEMODYNAMICS IN LIVING-RELATED LIVER TRANSPLANTATION IN CHILDRENTransplantation, 1995
- The incidence of portal vein thrombosis at liver transplantationJournal of Hepatology, 1992
- The role of spontaneous portosystemic shunts in the course of orthotopic liver transplantationTransplant International, 1992
- Portal HypertensionMedical Clinics of North America, 1989
- Studies on Portal HypertensionAnnals of Surgery, 1959