Abstract
BackgroundSitus 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 presentationA 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.ConclusionTo 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.
Highlights
Situs inversus is a rare congenital anomaly characterized by the complete inversion of thoracic and abdominal organs
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
Summary
The current case is the first report in adult LTx from SI donor to SI recipient. Given the limited experiences of LTx in SI, if situs matches, we suggest that it’s better to allocate SI donor to SI recipient. ABO-incompatibility is acceptable for donor allocation in cases that both donor and recipient are SI. Consent Written informed consents were obtained from both the recipient of the transplant and from the next-of-kin of the donor for publication of this case report and all accompanying images. Authors’ contributions YS reviewed the data and literature and wrote the manuscript. ZW and YJ participated in the donor procurement. YS, ZM and SY participated in the operation and the treatment of recipient. All authors have read and approved the final manuscript
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