Temporary portocaval shunt by piggyback cava in liver re-transplantation: report of a case.

Re-transplantation operation is a technically difficult procedure because of many adhesions; it has higher morbidity and mortality. In this article a maneuver facilitating liver re-transplantation is described. 27-year old male with hepatic artery thrombosis three months after the deceased liver transplantation admitted to our clinic for retransplantation. Related living right lobe liver transplantation was planned. During recipient’s hepatectomy, the hepatic hilum was transected first, but retroperitoneal dissection and identification of the patient’s vena cava was very difficult. Prolonged operative time and risk of mesenteric venous hypertension after the clamping of portal vein required an application of temporary porto-caval bypass. For this shunt the portal vein of recipient and lower end of cadaveric liver vena cava (“piggyback vena cava”) successfully and safely for temporary porto-caval shunt during the liver retransplantation.

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