Left lobe living donor liver transplantation in an adult patient with situs inversus: technical considerations

Transplant International : Official Journal of the European Society for Organ Transplantation
Yuji SoejimaYoshihiko Maehara

Abstract

Situs inversus (SI) is a rare congenital disorder involving a complete mirror image of the thoracic and abdominal organs. Living donor liver transplantation (LDLT) in SI cases poses particular challenges on account of its technical complexity, and only a few cases have been reported. Here, we present an adult with SI who was managed successfully by LDLT using a left lobe graft. Some technical modifications, including triangulated anastomosis of the hepatic vein, were required but no vascular graft was necessary. Graft function and vascular integrity were excellent throughout the postoperative course, although sepsis secondary to wound infection with methicillin-resistant Staphylococcus aureus developed. In conclusion, LDLT using a left lobe graft is a feasible procedure for patients with SI, even for adults. Therefore, this condition, while rare, should not be a contraindication for LDLT. Meticulous preoperative simulation and planning of the vascular reconstruction are important steps in LDLT for this rare anomaly.

References

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Citations

Oct 30, 2008·Surgery Today·Toru IkegamiHirofumi Kanemura
May 12, 2010·World Journal of Gastroenterology : WJG·Bong-Wan KimMyung-Wook Kim
Apr 15, 2014·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·H KameiY Ogura
Aug 14, 2010·Minimally Invasive Therapy & Allied Technologies : MITAT : Official Journal of the Society for Minimally Invasive Therapy·Takanori TokudaSatoshi Sawada
Mar 25, 2009·Current Opinion in Organ Transplantation

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