BioScience Trends Living donor liver transplantation for a patient with a history of total gastrectomy

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Author(s)

    • Shimata Keita
    • Department of Transplantation and Pediatric Surgery, Kumamoto University Graduate School of Medical Sciences
    • Irie Tomoaki
    • Department of Transplantation and Pediatric Surgery, Kumamoto University Graduate School of Medical Sciences
    • Kadohisa Masashi
    • Department of Transplantation and Pediatric Surgery, Kumamoto University Graduate School of Medical Sciences
    • Kawabata Seiichi
    • Department of Transplantation and Pediatric Surgery, Kumamoto University Graduate School of Medical Sciences
    • Ibuki Sho
    • Department of Transplantation and Pediatric Surgery, Kumamoto University Graduate School of Medical Sciences
    • Narita Yasuko
    • Department of Transplantation and Pediatric Surgery, Kumamoto University Graduate School of Medical Sciences
    • Yamamoto Hidekazu
    • Department of Transplantation and Pediatric Surgery, Kumamoto University Graduate School of Medical Sciences
    • Sugawara Yasuhiko
    • Department of Transplantation and Pediatric Surgery, Kumamoto University Graduate School of Medical Sciences
    • Hibi Taizo
    • Department of Transplantation and Pediatric Surgery, Kumamoto University Graduate School of Medical Sciences

Abstract

<p>Adhesions due to previous upper abdominal surgery may complicate later liver transplantation. Here we report successful living donor liver transplantation (LDLT) in a patient with a history of total gastrectomy. A 32-year-old Japanese woman developed end-stage liver failure due to alcoholic cirrhosis. She had undergone total gastrectomy, pancreato-splenectomy, and partial colectomy due to rupture of a pancreatic cyst. LDLT was performed using a right lobe graft from her sister. To minimize blood loss and injury to the jejunum, adhesions between the left lobe and nearby organs were dissected without blood flow in or out of the liver. The right liver graft was implanted uneventfully. She was extubated on postoperative day (POD) 1, but then developed septic shock due to aspiration pneumonia on POD 2. She was reintubated and antibiotics and antifungal agents were administered. Administration of tacrolimus was changed to an intravenous route on POD 3. Her condition improved and she was re-extubated on POD 9. On POD 14, tacrolimus was administered orally. She was discharged from our hospital on POD 30 without any other events and is doing well 6 months after LDLT. We believe that careful planning, such as mobilizing the left lobe with the blood flow blocked just before liver explantation, elevating the head of the bed during tube-feeding, and calculating the area under the curve after drug administration will enable liver transplantation for patients with a history of total gastrectomy.</p>

Journal

  • BioScience Trends

    BioScience Trends 13(2), 212-215, 2019

    International Research and Cooperation Association for Bio & Socio-Sciences Advancement

Codes

  • NII Article ID (NAID)
    130007644771
  • Text Lang
    ENG
  • ISSN
    1881-7815
  • Data Source
    J-STAGE 
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