Orthotopic liver transplantation in situs inversus adult from an ABO-incompatible donor with situs inversus

BMC Gastroenterology

Shusen Zheng¹  Min Zhang¹  Jian Wu¹  Sheng Yan¹  Jun Yu¹  Wu Zhang¹  Hua Guo¹  Songfeng Yu¹ 

[1] Key Laboratory of Organ Transplantation, Zhejiang Province, Hangzhou 310003, China

关键词: Abo incompatible;    Situs inversus;    Retransplantation;    Liver transplantation;   

Others  :  855672
DOI  :  10.1186/1471-230X-14-46

 received in 2013-08-10, accepted in 2014-02-24,  发布年份 2014

【 摘 要 】

Background

Situs inversus is a rare congenital anomaly characterized by the complete inversion of thoracic and abdominal organs. Liver transplantation in such patients or from donors in situs inversus is technically challenging because of the reversed anatomic structures. A small number of successful liver transplantation cases concerning situs inverus in either recipients or donors have been recently reported with different graft position and orientation. Here we reported an extremely rare case of liver retransplantation from an ABO incompatible situs inversus donor to an adult situs inversus recipient.

Case presentation

A 53-year-old complete situs inversus man developed graft failure due to severe biliary complication after his first liver transplantation from a situs solitus donor. Re-transplantation was performed using a graft liver from a likewise situs inversus donor. Although the blood type between donor and recipient was incompatible, the post-operative outcome was excellent under proper prophylaxis to the antibody-mediated rejection.

Conclusion

To the best of our knowledge, this is the first report of liver transplantation from situs inversus to situs inversus in adult recipient. Liver transplantation using situs matching donor makes the procedure much easier at the surgical point of view, which has a benefit of less potential surgical complications. Furthermore, ABO-incompatibility is acceptable for donor allocation in cases that both donor and recipient are situs inversus.

【 授权许可】

   
2014 Yu et al.; licensee BioMed Central Ltd.

【 图 表 】

【 参考文献 】

• [1]Yokoyama T, Copeland NG, Jenkins NA, Montgomery CA, Elder FF, Overbeek PA: Reversal of left-right asymmetry: a situs inversus mutation. Science 1993, 260(5108):679-682.
• [2]Braun F, Rodeck B, Lorf T, Canelo R, Wietzke P, Hartmann H, Ramadori G, Ringe B: Situs inversus of donor or recipient in liver transplantation. Transpl Int 1998, 11(3):212-215.
• [3]Raynor SC, Wood RP, Spanta AD, Shaw BW Jr: Liver transplantation in a patient with abdominal situs inversus. Transplantation 1988, 45(3):661-663.
• [4]Watson CJ, Rasmussen A, Jamieson NV, Friend PJ, Johnston PS, Barnes ND, Calne RY: Liver transplantation in patients with situs inversus. Br J Surg 1995, 82(2):242-245.
• [5]Rayhill SC, Scott D, Orloff S, Horn JL, Schwartz J, Zaman A, Sasaki A, Naugler WS, Chang M, Gaumond J, Wu Y, Ham J: Orthotopic, but reversed implantation of the liver allograft in situs inversus totalis-a simple new approach to a difficult problem. Am J Transplant 2009, 9(7):1602-1606.
• [6]Herrera LA, Castillo J, Martino E, Rabanal JM, Fleitas MG: Orthotopic liver transplantation from a donor with abdominal situs inversus. Transplantation 1996, 62(1):133-135.
• [7]Wente MN, Thorn M, Radeleff B, Dei-Anane G, Mehrabi A, Sauer P, Buchler MW, Schmidt J, Kraus TW, Schemmer P: A routine liver transplantation in a patient with situs inversus: a case report and an overview of the literature. Clin Transplant 2006, 20(2):151-155.
• [8]Klintmalm GB, Bell MS, Husberg BS, Holman MJ, Goldstein RM, Ramsay MA, Polter DE: Liver transplant in complete situs inversus: a case report. Surgery 1993, 114(1):102-106.
• [9]Tucker O, Prachalias A, Kane P, Rela M: Graft positioning at liver transplantation in situs inversus. Liver Transpl 2006, 12(11):1720-1722.
• [10]Asfar S, Ozcay N, Grant D, Wall W: Transplantation of the liver from a donor with complete situs inversus and dextrocardia. Transplantation 1995, 59(3):442-444.
• [11]Hoyos S, Guzman C, Correa G, Restrepo JC, Franco H, Cardenas A: Orthotopic liver transplantation in an adult with situs inversus: an easy way to fit the liver. Ann Hepatol 2006, 5(1):53-55.
• [12]Pomposelli JJ, DaCosta MA, McPartland K, Jenkins RL: Retroversus implantation of a liver graft: a novel approach to the deceased donor with situs inversus totalis. Am J Transplant 2007, 7(7):1869-1871.
• [13]Polak WG, Chudoba PJ, Patrzalek D, Szyber P: Organ donor with complete situs inversus. Case report and review of the literature. Ann Transplant 2006, 11(1):43-46.
• [14]Sugawara Y, Makuuchi M, Takayama T, Yoshino H, Mizuta K, Kawarasaki H: Liver transplantation from situs inversus to situs inversus. Liver Transpl 2001, 7(9):829-830.
• [15]Soejima Y, Meguro M, Taketomi A, Ikegami T, Yamashita Y, Harada N, Ito S, Uchiyama H, Yoshizumi T, Maehara Y: Left lobe living donor liver transplantation in an adult patient with situs inversus: technical considerations. Transpl Int 2008, 21(4):384-389.
• [16]Chun JM, Jung GO, Choi GS, Park JB, Kwon CH, Kim SJ, Joh JW, Lee SK: Living donor liver transplantation using a graft from a donor with situs inversus totalis. Liver Transpl 2009, 15(6):666-669.
• [17]Tanabe M, Kawachi S, Obara H, Shinoda M, Hibi T, Kitagawa Y, Wakabayashi G, Shimazu M, Kitajima M: Current progress in ABO-incompatible liver transplantation. Eur J Clin Invest 2010, 40(10):943-949.
• [18]Raut V, Uemoto S: Management of ABO-incompatible living-donor liver transplantation: past and present trends. Surg Today 2011, 41(3):317-322.
• [19]Ikegami T, Shirabe K, Soejima Y, Taketomi A, Maehara Y: Feasibility of ABO-incompatible living donor liver transplantation in the rituximab era. Liver Transpl 2010, 16(11):1332-1333. author reply 1334–1335
• [20]Raut V, Mori A, Kaido T, Ogura Y, Taku I, Nagai K, Sasaki N, Endo K, Hata T, Yagi S, Egawa H, Uemoto S: Splenectomy does not offer immunological benefits in ABO-incompatible liver transplantation with a preoperative rituximab. Transplantation 2012, 93(1):99-105.