Liver Transplant Research Today is a free monthly online journal that collates and summarizes the latest research about Liver Transplant, including details on risks, prognosis, procedure, surgery, organ donation.

Retroversus implantation of a liver graft: a novel approach to the deceased donor with situs inversus totalis.

Pomposelli JJ, DaCosta MA, McPartland K, Jenkins RL

Division of Hepatobiliary Surgery and Liver Transplantation, Lahey Clinic Medical Center, Burlington, MA, USA. J.Pomposelli@lahey.org

Situs inversus totalis is a rare anatomical abnormality that results in dextrocardia, mirror image of normal abdominal organs and other congenital abnormalities. Deceased donors with this condition are often declined on anatomic concerns. While there have been numerous reports of successful liver transplantation in recipients with situs inversus, review of the world's literature provided only three case reports using deceased donors with situs inversus. In this report, a novel approach to implantation of a liver graft from a donor with situs inversus is presented. To avoid possible torsion and blockage of venous outflow, a modified retroversus piggyback technique with 180 degrees ventral caudal (backwards) rotation of the liver graft along the axis of the vena cava was performed. This orientation resulted in the retro hepatic vena cava facing anteriorly and the larger anatomic liver lobe in the right upper quadrant. Excellent outcome was achieved without technical difficulty. Retroversus implantation of a liver graft from a donor with situs inversus is safe and effective and associated with favorable outcome.

Published 13 June 2007 in Am J Transplant, 7(7): 1869-71.
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