Renal-splenic shunt for infrahepatic caval occlusion after piggy-back liver transplantation

Vincenzo Mazzaferro, Enrico Regalia, Andrea Pulvirenti, Dario Baratti, Giuseppe Montagnino, Federico Bozzetti

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Inferior vena cava thrombosis after liver transplantation is uncommon. We describe a case of this unusual complication occurring after piggy-back (end-to-side) graft implantation. Renal failure, lower limb edema, and hemodynamic instability were the presenting symptoms requiring immediate surgical correction with a left renal-to-splenic vein shunt over a ringed 2.5-cm prosthesis. The decision to go ahead with the shunt was preceded by an intraoperative confirmation of a 10-cm H2O pressure gradient between the caval and portal circulations. This gradient, unlike that observed in liver cirrhosis, ultimately turned a splenorenal shunt into a renal-splenic one. Six months after the procedure, the patient is alive and well with normal liver and renal function. The technique described may be useful in the management of other clinical conditions of acute infrahepatic caval hypertension.

Original languageEnglish
Pages (from-to)392-394
Number of pages3
JournalTransplant International
Volume10
Issue number5
DOIs
Publication statusPublished - Sep 1997

Fingerprint

Venae Cavae
Liver Transplantation
Kidney
Surgical Splenorenal Shunt
Splenic Vein
Inferior Vena Cava
Liver Cirrhosis
Prostheses and Implants
Renal Insufficiency
Lower Extremity
Edema
Thrombosis
Hemodynamics
Hypertension
Transplants
Pressure
Liver

Keywords

  • Liver transplantation
  • Splenorenal shunt
  • Vena cava thrombosis

ASJC Scopus subject areas

  • Transplantation

Cite this

Renal-splenic shunt for infrahepatic caval occlusion after piggy-back liver transplantation. / Mazzaferro, Vincenzo; Regalia, Enrico; Pulvirenti, Andrea; Baratti, Dario; Montagnino, Giuseppe; Bozzetti, Federico.

In: Transplant International, Vol. 10, No. 5, 09.1997, p. 392-394.

Research output: Contribution to journalArticle

@article{81255411f29a4329aaeeda91a5ad72bd,
title = "Renal-splenic shunt for infrahepatic caval occlusion after piggy-back liver transplantation",
abstract = "Inferior vena cava thrombosis after liver transplantation is uncommon. We describe a case of this unusual complication occurring after piggy-back (end-to-side) graft implantation. Renal failure, lower limb edema, and hemodynamic instability were the presenting symptoms requiring immediate surgical correction with a left renal-to-splenic vein shunt over a ringed 2.5-cm prosthesis. The decision to go ahead with the shunt was preceded by an intraoperative confirmation of a 10-cm H2O pressure gradient between the caval and portal circulations. This gradient, unlike that observed in liver cirrhosis, ultimately turned a splenorenal shunt into a renal-splenic one. Six months after the procedure, the patient is alive and well with normal liver and renal function. The technique described may be useful in the management of other clinical conditions of acute infrahepatic caval hypertension.",
keywords = "Liver transplantation, Splenorenal shunt, Vena cava thrombosis",
author = "Vincenzo Mazzaferro and Enrico Regalia and Andrea Pulvirenti and Dario Baratti and Giuseppe Montagnino and Federico Bozzetti",
year = "1997",
month = "9",
doi = "10.1007/s001470050076",
language = "English",
volume = "10",
pages = "392--394",
journal = "Transplant International",
issn = "0934-0874",
publisher = "Blackwell Publishing Ltd",
number = "5",

}

TY - JOUR

T1 - Renal-splenic shunt for infrahepatic caval occlusion after piggy-back liver transplantation

AU - Mazzaferro, Vincenzo

AU - Regalia, Enrico

AU - Pulvirenti, Andrea

AU - Baratti, Dario

AU - Montagnino, Giuseppe

AU - Bozzetti, Federico

PY - 1997/9

Y1 - 1997/9

N2 - Inferior vena cava thrombosis after liver transplantation is uncommon. We describe a case of this unusual complication occurring after piggy-back (end-to-side) graft implantation. Renal failure, lower limb edema, and hemodynamic instability were the presenting symptoms requiring immediate surgical correction with a left renal-to-splenic vein shunt over a ringed 2.5-cm prosthesis. The decision to go ahead with the shunt was preceded by an intraoperative confirmation of a 10-cm H2O pressure gradient between the caval and portal circulations. This gradient, unlike that observed in liver cirrhosis, ultimately turned a splenorenal shunt into a renal-splenic one. Six months after the procedure, the patient is alive and well with normal liver and renal function. The technique described may be useful in the management of other clinical conditions of acute infrahepatic caval hypertension.

AB - Inferior vena cava thrombosis after liver transplantation is uncommon. We describe a case of this unusual complication occurring after piggy-back (end-to-side) graft implantation. Renal failure, lower limb edema, and hemodynamic instability were the presenting symptoms requiring immediate surgical correction with a left renal-to-splenic vein shunt over a ringed 2.5-cm prosthesis. The decision to go ahead with the shunt was preceded by an intraoperative confirmation of a 10-cm H2O pressure gradient between the caval and portal circulations. This gradient, unlike that observed in liver cirrhosis, ultimately turned a splenorenal shunt into a renal-splenic one. Six months after the procedure, the patient is alive and well with normal liver and renal function. The technique described may be useful in the management of other clinical conditions of acute infrahepatic caval hypertension.

KW - Liver transplantation

KW - Splenorenal shunt

KW - Vena cava thrombosis

UR - http://www.scopus.com/inward/record.url?scp=0030838991&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030838991&partnerID=8YFLogxK

U2 - 10.1007/s001470050076

DO - 10.1007/s001470050076

M3 - Article

VL - 10

SP - 392

EP - 394

JO - Transplant International

JF - Transplant International

SN - 0934-0874

IS - 5

ER -