Left renal vein ligation for large splenorenal shunt during liver transplantation. Issue 10 (29th August 2017)

• Record Type: Journal Article
• Authors: Tang, Rui; Han, Dongdong; Li, Modan; Shen, Shan; Huang, Xin; Zhao, Wenping; Dong, Jiahong
• Is Part Of: ANZ journal of surgery. Volume 87:Issue 10(2017)
• Page Start: 767
• Page End: 772
• Publication Date: 2017-08-29
• Subjects: flow metre -- left renal vein ligation -- liver transplantation -- portal steal syndrome -- splenorenal shunt; Surgery -- Periodicals; 617.005
• DOI: 10.1111/ans.14044
• Languages: English
• ISSNs: 1445-1433

Abstract

Abstract : Adequate hepatopetal portal vein blood flow is obligatory to ensure proper liver function after liver transplantation. Large collateral veins as shunts impair portal vein flow and even cause hepatofugal blood flow and portal steal syndrome. In particular, splenorenal shunts in liver transplant recipients can lead to allograft dysfunction and possible allograft loss or hepatic encephalopathy. Restoration of portal flow through left renal vein ligation (LRVL) is a treatment option, which is much easier compared to splenectomy, renoportal anastomosis and shunt closure, but bears the risk of moderate and temporary impairment of renal function. In addition, a patent portal vein is mandatory for LRVL. However, although LRVL has been reported to be an effective, safe and easy method to control portacaval shunts and increase hepatopetal flow in some studies, indications and safety are still not clear. In this review, we summarize existing studies on LRVL during liver transplantation.