Role of portocaval shunts in development of complications after liver transplantation

D. L. Tsoy, M. Prudkov, O. G. Orlov, E. Bessonova, I. G. Leshchenko, L. Kardopoltsev, A. Ageev, S. Solodushkin
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Abstract

Rationale. Portal blood flow is a key component in the viability of the liver transplant.Portocaval shunts formed on the background of the liver cirrhosis before transplantation can cause portal vein steal syndrome, with subsequent development of ischemic necrosis of the graft.To date, the tactics of treating patients with portal vein steal syndrome during liver transplantation has not been sufficiently developed.This paper presents a literature review and our own experience on this important, but little-studied issue.Purpose. The purpose of this research is to study the role of portocaval shunts in the development of complications after liver transplantation, based on a retrospective analysis of clinical cases.Conclusions. In liver transplantation, portocaval shunts can cause the development of portal vein steal syndrome with subsequent development of liver failure. For the diagnosis of portal vein steal syndrome, it is important to use the data obtained at all stages of liver transplantation. Surgical correction of portal vein steal syndrome can be performed during liver transplantation and in the early postoperative period.
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门静脉分流在肝移植术后并发症发生中的作用
基本原理。门静脉血流是肝移植存活的关键因素。在移植前肝硬化背景下形成的门静脉分流可引起门静脉偷取综合征,随后发展为移植物缺血性坏死。迄今为止,肝移植过程中门静脉偷取综合征的治疗策略还没有得到充分的发展。本文对这一重要但研究较少的问题进行了文献综述和我们自己的经验。本研究的目的是通过对临床病例的回顾性分析,探讨门静脉分流在肝移植术后并发症发生中的作用。在肝移植中,门静脉分流可引起门静脉偷取综合征,随后发展为肝衰竭。对于门静脉偷取综合征的诊断,重要的是使用在肝移植的各个阶段获得的数据。门静脉偷取综合征的手术矫正可在肝移植期间及术后早期进行。
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