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Living domino liver transplantation in an adult with congenital absence of portal vein.

Abstract
Congenital absence of the portal vein (CAPV) is a rare malformation of the splanchnic venous system. Although CAPV is usually detected in the pediatric age group, our patient was a 35-year-old woman. She had been diagnosed with CAPV in 1996 when she was 27 years old. In 1998, she was placed on hemodialysis due to chronic renal failure. After several episodes of encephalopathy in 2002, liver transplantation (LT) was recommended to her and her family. Since there was no suitable living donor candidate, she was put on the waiting list for a deceased donor liver transplant in Japan. In 2004, her ammonia level increased to around 300 microg/dl, and she went into a coma lasting for three days. After recovering from this event, she underwent a living domino transplantation using a whole liver donated by a familial amyloid polyneuropathy (FAP) patient. Her portal vein, which had drained directly into the inferior vena cava (IVC), was transected together with a cuff of the IVC wall and anastomosed to the graft liver portal vein in an end-to-end fashion. In conclusion, liver transplantation proved to be a safe and effective way to save this patient and improve her quality of life.
AuthorsTakayuki Takeichi, Hideaki Okajima, Hiroko Suda, Shintarou Hayashida, Hironori Iwasaki, Manuel Zeledon Ramirez, Mikako Ueno, Katsuhiro Asonuma, Yukihiro Inomata
JournalLiver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society (Liver Transpl) Vol. 11 Issue 10 Pg. 1285-8 (Oct 2005) ISSN: 1527-6465 [Print] United States
PMID16184557 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Ammonia
Topics
  • Adult
  • Ammonia (blood)
  • Amyloid Neuropathies (surgery)
  • Anastomosis, Surgical
  • Drainage
  • Female
  • Humans
  • Liver Transplantation (methods)
  • Living Donors
  • Portal Vein (abnormalities, surgery)
  • Splanchnic Circulation
  • Tissue and Organ Harvesting (methods)
  • Treatment Outcome
  • Vena Cava, Inferior (surgery)

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