Side-to-side caval anastomosis in a patient receiving a liver graft from a marginal donor with situs inversus totalis. (2015)

• Record Type: Journal Article
• Authors: Manzia, Tommaso Maria; Tariciotti, Laura; Angelico, Roberta; Toti, Luca; Anselmo, Alessandro; Tisone, Giuseppe
• Is Part Of: International journal of surgery case reports. Volume 6(2015)
• Page Start: 222
• Page End: 225
• Publication Date: 2015
• Subjects: SIT situs inversus totalis -- LT liver transplantation; Situs inversus totalis -- Marginal donor -- Liver transplantation -- Piggyback technique; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2014.10.037
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: Liver transplantation using a donor with situs inversus totalis is feasible and safe. The anatomical anomalies in the donor with situs inversus totalis should not be considered a controindication to liver transplantation. The 1992-Belghiti piggyback technique represents an excellent surgery option for liver transplantation. Abstract: Introduction: The donor situs inversus totalis status was considered an absolute contraindication to liver transplantation due to the technical difficulties involved. Only in recent years has a very young deceased donor with situs inversus totalis been considered as a potential donor. Presentation of case: We herein report a single case of 57-year-old male patient with hepatocellular carcinoma who received a liver transplantation from a 73-year-old woman with situs inversus totalis. Liver was implanted using a 1992-Belghiti piggyback technique positioning the larger hemiliver in the left upper quadrant and the left in the liver fossa. We assisted a good graft reperfusion without surgical or anesthetic problems. His hospital stay was relatively uneventful and he was discharged from hospital on postoperative day 7. At 8 months of follow-up the patient is alive and in good clinical condition. Discussion: The donor situs inversus totalis does not require any modification of transplant procedure if the donor–recipient size match permits a comfortable placement of the graft in a standard anatomical position. To the best of our knowledge, this is the first case of liver transplantation with a graft from a "marginal" donor with situs inversus totalis using a 1992-Belghiti piggyback technique. Conclusion: The donor situs inversus totalis status should not be considered a contraindication for LT and the piggyback technique should be considered the surgery of choice.