Heterotopic liver Re-transplantation in the splenic fossa скачать в хорошем качестве

Heterotopic liver Re-transplantation in the splenic fossa

Professor AZOULAY - APHP Henri Mondor (Paris, France) : In rare cases, the first step of standard orthotopic liver re-transplantation (re-TX) i.e. the failing graft explantation is deemed impossible due to early massive hemorrhage. In this setting, the surgery is aborted, and the patient dies shorty due to a combination of hemorrhage and multiple organ failure. In addition, the subsequent "orphan graft" is often discarded due to the logistical impossibility to allocate it to another recipient due to a prohibitive duration of cold ischemia time. We report here a case where both re-Tx was impossible and the graft could not be reallocated. Instead of enduring this situation, we resorted to a technique that was not used for decades, namely heterotopic liver transplantation in the splenic fossa. This procedure was successful and the patient is currently alive with normal liver function more than 9 months post-re-Tx.