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

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

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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
Issue number5
Publication statusPublished - Sep 1997


  • Liver transplantation
  • Splenorenal shunt
  • Vena cava thrombosis

ASJC Scopus subject areas

  • Transplantation


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