|
|
|
| Total hepatectomy and modified temporary porto-caval shunt as a useful bridge to urgent retransplantation |
| Samuele Iesari1,2, Maxime Foguenne1, Jan Lerut1,* |
1 Starzl Abdominal Transplant Unit, University Hospitals Saint-Luc, Université catholique de Louvain, Avenue Hippocrate 10, 1200 Brussels, Belgium
2 Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Via Pompeo Spennati – Delta 6, 67100 L’Aquila, Italy
*Corresponding Author.
E-mail: jan.lerut@uclouvain.be |
|
|
|
Abstract The original technique of liver transplantation (LT) described by Starzl in 1963 included the removal of the recipient inferior vena cava (IVC) with use of extracorporeal veno-venous bypass (VVB). Since then, the majority of transplant centres evolved towards an IVC sparing hepatectomy with or without temporary porto-caval shunting (PCSh) [1]. In 1988, the Hannover group reported about a two-stage total hepatectomy technique with temporary PCSh and subsequent liver re-transplantation (re-LT) in order to overcome the consequences of the “toxic liver allograft syndrome” [2]. Later on, this approach has also
been applied in case of fulminant hepatic failure, severe hepatic trauma, spontaneous hepatic rupture, hemorrhagic necrosis and primary non-function of
the allograft in order to overcome lifethreatening hemodynamic and/or metabolic disturbances and to bring the patient in the best possible condition to LT or re-LT [3].
|
|
|
|
|
|
|
|
|
