Liver Transplantation in Situs Inversus and Portal Vein Thrombosis (First Case Report in Russia)

Abstract

Situs inversus is a rare mirror transposition of internal organs relative to the median plane. Liver transplantation in situs inversus is a serious medical challenge imposed by an abnormal arrangement of the recipient's organs. Aim . Clinical description of a successful cadaveric liver transplantation in an adult patient with situs inversus and portal vein thrombosis. Key points . A 32 years-old patient with situs inversus , chronic hepatitis B/D-induced liver cirrhosis and portal vein thrombosis had cadaveric liver transplantation, with the transplant reoriented in abdominal cavity 90° clockwise relative to the median plane. End-to-side cavocaval anastomosis was formed between the donor's retrohepatic and the recipient's main inferior vena cava, with successive portal and arterial anastomoses and complete donor liver reperfusion. A biliary reconstruction was performed with an end-to-end biliobiliary anastomosis. The surgery duration comprised 5 h 20 min, intraoperative blood loss — 2000 mL, cold ischemia time — 4 h. The patient was discharged on the 10 th day after surgery in satisfactory condition. Conclusion . Situs inversus is not a contraindication to liver transplantation.