J Korean Soc Transplant.
2005 Dec;19(2):182-191.
Ligation of Left Renal Vein for Splenorenal Collateral Shunt to Prevent Portal Flow Steal in Adult Living Donor Liver Transplantation
- Affiliations
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- 1Department of Surgery, Division of Hepatobiliary Surgery and Liver Transplantation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. sglee2@amc.seoul.kr
- 2Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Abstract
- PURPOSE
To assess the safety and role of ligation of left renal vein (LRV) to avoid portal flow steal to the partial liver graft when living donor liver transplantation (LDLT) is performed for the cirrhotic patients with large spontaneous splenorenal shunt (SRS).
METHODS
Between 2001 and 2005, 44 portal hypertensive patients with large SRS who underwent ligation of LRV were retrospectively reviewed.
RESULTS
After ligation of LRV, thirty four patients of 44 pateints (77.3%) revealed hypo-attenuation of left kidney on computed tomography but 10 patients (22.7%) showed normal attenuation. Proteinuria and hematuria occurred in 22 patients (50%) and 43 patients (97.7%) respectively after operation, but nearly all of them recovered. Decreased urine outputs (less than 1,000 mL per day) appeared in 4 patients (9.1%), but disappeared after dialysis for 6+/-5.4 days. Serum creatinine increased in 43 patients (97.7%), but decreased to normal range in 40 patients (90.3%). During study period, portal flow steal to the liver graft did not occur after ligation of LRV, and liver regeneration was satisfactory.
CONCLUSION
It seems to be a good graft salvage procedure for the portal hypertensive patients who demonstrate large SRS after partial liver engraftment.
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