Left renal vein ligation for large splenorenal shunt during liver transplantation.

Abstract:

:Adequate hepatopetal portal vein blood flow is obligatory to ensure proper liver function after liver transplantation. Large collateral veins as shunts impair portal vein flow and even cause hepatofugal blood flow and portal steal syndrome. In particular, splenorenal shunts in liver transplant recipients can lead to allograft dysfunction and possible allograft loss or hepatic encephalopathy. Restoration of portal flow through left renal vein ligation (LRVL) is a treatment option, which is much easier compared to splenectomy, renoportal anastomosis and shunt closure, but bears the risk of moderate and temporary impairment of renal function. In addition, a patent portal vein is mandatory for LRVL. However, although LRVL has been reported to be an effective, safe and easy method to control portacaval shunts and increase hepatopetal flow in some studies, indications and safety are still not clear. In this review, we summarize existing studies on LRVL during liver transplantation.

journal_name

ANZ J Surg

journal_title

ANZ journal of surgery

authors

Tang R,Han D,Li M,Shen S,Huang X,Zhao W,Dong J

doi

10.1111/ans.14044

subject

Has Abstract

pub_date

2017-10-01 00:00:00

pages

767-772

issue

10

eissn

1445-1433

issn

1445-2197

journal_volume

87

pub_type

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