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KMID : 0361120050190020182
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Korean Journal of Transplantation
2005 Volume.19 No. 2 p.182 ~ p.191
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Ligation of Left Renal Vein for Splenorenal Collateral Shunt to Prevent Portal Flow Steal in Adult Living Donor Liver Transplantation
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문덕복/Moon DB
이승규/황신/김기훈/안철수/하태용/박광민/송기원/김동식/정재필/문기명/정동환/Lee SG/Hwang S/Kim KH/Ahn CS/Ha TY/Park KM/Song GW/Kim DS/Jung JP/Moon KM/Jung DH
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Abstract
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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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