Temporary portocaval shunt and total hepatectomy is a technique used in the presence of toxic liver syndrome because of fulminant hepatic failure, hepatic trauma, primary non-function (PNF), and eclampsia. We performed this technique on four patients. An indication for anhepatic state was severe hemodynamic instability in three of them. Etiologies of these three patients were as follows: PNF after liver transplantation, ischemic hepatitis after right hepatic artery embolization, and massive reperfusion syndrome during a liver transplantation. In the fourth patient, during the liver transplantation when hepatic artery was ligated, a kidney carcinoma in the donor graft was discovered. We decided to complete the hepatectomy and to construct a temporary portocaval shunt. Mean anhepatic phases were 19 h and 15 min. All patients survived the two-stage liver transplantation procedure without major complications. Our cases demonstrated that temporary portocaval shunt while awaiting urgent liver transplantation could be an effective "bridge" in selected patients who develop toxic liver syndrome; however, a short time between portocaval shunt and transplantation and careful intensive care managements are mandatory.

Two-stage liver transplantation: an effective procedure in urgent conditions / Montalti, R.; Busani, S.; Masetti, M.; Girardis, Massimo; Benedetto, F. D.; Begliomini, B.; Rompianesi, G.; Rinaldi, L.; Ballarin, R.; Pasetto, A.; Gerunda, Giorgio Enrico. - In: CLINICAL TRANSPLANTATION. - ISSN 0902-0063. - STAMPA. - 24:(2010), pp. 122-126. [10.1111/j.1399-0012.2009.01118.x]

Two-stage liver transplantation: an effective procedure in urgent conditions.

S. Busani;GIRARDIS, Massimo;GERUNDA, Giorgio Enrico
2010-01-01

Abstract

Temporary portocaval shunt and total hepatectomy is a technique used in the presence of toxic liver syndrome because of fulminant hepatic failure, hepatic trauma, primary non-function (PNF), and eclampsia. We performed this technique on four patients. An indication for anhepatic state was severe hemodynamic instability in three of them. Etiologies of these three patients were as follows: PNF after liver transplantation, ischemic hepatitis after right hepatic artery embolization, and massive reperfusion syndrome during a liver transplantation. In the fourth patient, during the liver transplantation when hepatic artery was ligated, a kidney carcinoma in the donor graft was discovered. We decided to complete the hepatectomy and to construct a temporary portocaval shunt. Mean anhepatic phases were 19 h and 15 min. All patients survived the two-stage liver transplantation procedure without major complications. Our cases demonstrated that temporary portocaval shunt while awaiting urgent liver transplantation could be an effective "bridge" in selected patients who develop toxic liver syndrome; however, a short time between portocaval shunt and transplantation and careful intensive care managements are mandatory.
24
122
126
Two-stage liver transplantation: an effective procedure in urgent conditions / Montalti, R.; Busani, S.; Masetti, M.; Girardis, Massimo; Benedetto, F. D.; Begliomini, B.; Rompianesi, G.; Rinaldi, L.; Ballarin, R.; Pasetto, A.; Gerunda, Giorgio Enrico. - In: CLINICAL TRANSPLANTATION. - ISSN 0902-0063. - STAMPA. - 24:(2010), pp. 122-126. [10.1111/j.1399-0012.2009.01118.x]
Montalti, R.; Busani, S.; Masetti, M.; Girardis, Massimo; Benedetto, F. D.; Begliomini, B.; Rompianesi, G.; Rinaldi, L.; Ballarin, R.; Pasetto, A.; Gerunda, Giorgio Enrico
File in questo prodotto:
File Dimensione Formato  
Two-stage liver transplantation- an effective procedure in urgent conditions.pdf

Accesso riservato

Dimensione 78.5 kB
Formato Unknown
78.5 kB Unknown   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

Licenza Creative Commons
I metadati presenti in IRIS UNIMORE sono rilasciati con licenza Creative Commons CC0 1.0 Universal, mentre i file delle pubblicazioni sono rilasciati con licenza Attribuzione 4.0 Internazionale (CC BY 4.0), salvo diversa indicazione.
In caso di violazione di copyright, contattare Supporto Iris

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/731247
Citazioni
  • ???jsp.display-item.citation.pmc??? 3
  • Scopus 18
  • ???jsp.display-item.citation.isi??? 12
social impact