Inferior mesenteric venous left renal vein shunting for decompression of excessive portal hypertension in adult living related liver transplantation |
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| Authors: | Sato Y Yamamoto S Takeishi T Kato T Nakatsuka H Kobayashi T Oya H Watanabe T Kokai H Hatakeyama K |
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| Institution: | a Department of Regenerative and Transplant Medicine, Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan |
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| Abstract: | In the present study, we investigated the effect of decompression of excessive portal hypertension by inferior mesenteric venous (IMV) left renal vein shunting in 7 cirrhotic patients with esophago-gastric varices and 2 patients who underwent adult living related donor liver transplantation (ALRDLT). The portal pressure remarkably decreased after shunting in all patients with esophago-gastric varices (388 ± 42 mm H2O vs. 247 ± 57 mm H2O; P < .05). It also decreased after a shunt operation in patients who had undergone liver transplantation. We report that the excessive shear stress by portal hypertension after small-for-size LRDLT induces a liver injury and the decompression of portal hypertension by splenic arterial ligation or splenectomy prevents postoperative liver injury following massive hepatectomy and small-for-size LRDLT. Our present studies suggested that IMV left renal vein shunting might prevent postoperative liver injury by partial decompression of excessive portal hypertension following small-for-size LRDLT. |
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