Ligation of Left Renal Vein for Spontaneous Splenorenal Shunt to Prevent Portal Hypoperfusion after Orthotopic Liver Transplantation
We report a case of recovered portal flow by ligation of the left renal vein on the first postoperative day after orthotopic liver transplantation of a 54-year-old female with alcoholic liver cirrhosis, chronic kidney failure, and spontaneous splenorenal shunt. After reperfusion, Doppler ultrasonogr...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Case Reports in Transplantation |
| Online Access: | http://dx.doi.org/10.1155/2013/842538 |
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| author | Lampros Kousoulas Kristina Imeen Ringe Michael Winkler Frank Lehner Nicolas Richter Juergen Klempnauer Fabian Helfritz |
| author_facet | Lampros Kousoulas Kristina Imeen Ringe Michael Winkler Frank Lehner Nicolas Richter Juergen Klempnauer Fabian Helfritz |
| author_sort | Lampros Kousoulas |
| collection | DOAJ |
| description | We report a case of recovered portal flow by ligation of the left renal vein on the first postoperative day after orthotopic liver transplantation of a 54-year-old female with alcoholic liver cirrhosis, chronic kidney failure, and spontaneous splenorenal shunt. After reperfusion, Doppler ultrasonography showed almost total diversion of the portal flow into the existing splenorenal shunt, but because of severe coagulopathy and diffuse bleeding, ligation of the shunt was not attempted. A programmed relaparotomy was performed on the first postoperative day, and the left renal vein was ligated just to the left of the inferior vena cava. Portal flows subsequently increased to 37 cm/sec, and the patient presented a good and stable liver function. We conclude that patients with known preoperative splenorenal shunts should be closely monitored, and if the portal flow becomes insufficient, ligation of the left renal vein should be attempted in order to optimize the portal perfusion of the liver. |
| format | Article |
| id | doaj-art-d40c5a72a5754034bca1e580d237b7af |
| institution | Kabale University |
| issn | 2090-6943 2090-6951 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Transplantation |
| spelling | doaj-art-d40c5a72a5754034bca1e580d237b7af2025-02-03T05:46:38ZengWileyCase Reports in Transplantation2090-69432090-69512013-01-01201310.1155/2013/842538842538Ligation of Left Renal Vein for Spontaneous Splenorenal Shunt to Prevent Portal Hypoperfusion after Orthotopic Liver TransplantationLampros Kousoulas0Kristina Imeen Ringe1Michael Winkler2Frank Lehner3Nicolas Richter4Juergen Klempnauer5Fabian Helfritz6Department of General, Visceral and Transplant Surgery, Hannover Medical School, Carl-Neuberg-Street 1, 30625 Hanover, GermanyInstitute of Radiology, Hannover Medical School, Carl-Neuberg-Street 1, 30625 Hanover, GermanyDepartment of General, Visceral and Transplant Surgery, Hannover Medical School, Carl-Neuberg-Street 1, 30625 Hanover, GermanyDepartment of General, Visceral and Transplant Surgery, Hannover Medical School, Carl-Neuberg-Street 1, 30625 Hanover, GermanyDepartment of General, Visceral and Transplant Surgery, Hannover Medical School, Carl-Neuberg-Street 1, 30625 Hanover, GermanyDepartment of General, Visceral and Transplant Surgery, Hannover Medical School, Carl-Neuberg-Street 1, 30625 Hanover, GermanyDepartment of General, Visceral and Transplant Surgery, Hannover Medical School, Carl-Neuberg-Street 1, 30625 Hanover, GermanyWe report a case of recovered portal flow by ligation of the left renal vein on the first postoperative day after orthotopic liver transplantation of a 54-year-old female with alcoholic liver cirrhosis, chronic kidney failure, and spontaneous splenorenal shunt. After reperfusion, Doppler ultrasonography showed almost total diversion of the portal flow into the existing splenorenal shunt, but because of severe coagulopathy and diffuse bleeding, ligation of the shunt was not attempted. A programmed relaparotomy was performed on the first postoperative day, and the left renal vein was ligated just to the left of the inferior vena cava. Portal flows subsequently increased to 37 cm/sec, and the patient presented a good and stable liver function. We conclude that patients with known preoperative splenorenal shunts should be closely monitored, and if the portal flow becomes insufficient, ligation of the left renal vein should be attempted in order to optimize the portal perfusion of the liver.http://dx.doi.org/10.1155/2013/842538 |
| spellingShingle | Lampros Kousoulas Kristina Imeen Ringe Michael Winkler Frank Lehner Nicolas Richter Juergen Klempnauer Fabian Helfritz Ligation of Left Renal Vein for Spontaneous Splenorenal Shunt to Prevent Portal Hypoperfusion after Orthotopic Liver Transplantation Case Reports in Transplantation |
| title | Ligation of Left Renal Vein for Spontaneous Splenorenal Shunt to Prevent Portal Hypoperfusion after Orthotopic Liver Transplantation |
| title_full | Ligation of Left Renal Vein for Spontaneous Splenorenal Shunt to Prevent Portal Hypoperfusion after Orthotopic Liver Transplantation |
| title_fullStr | Ligation of Left Renal Vein for Spontaneous Splenorenal Shunt to Prevent Portal Hypoperfusion after Orthotopic Liver Transplantation |
| title_full_unstemmed | Ligation of Left Renal Vein for Spontaneous Splenorenal Shunt to Prevent Portal Hypoperfusion after Orthotopic Liver Transplantation |
| title_short | Ligation of Left Renal Vein for Spontaneous Splenorenal Shunt to Prevent Portal Hypoperfusion after Orthotopic Liver Transplantation |
| title_sort | ligation of left renal vein for spontaneous splenorenal shunt to prevent portal hypoperfusion after orthotopic liver transplantation |
| url | http://dx.doi.org/10.1155/2013/842538 |
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