Please use this identifier to cite or link to this item: https://observatorio.fm.usp.br/handle/OPI/2650
Title: REX SHUNT FOR ACUTE PORTAL VEIN THROMBOSIS AFTER PEDIATRIC LIVER TRANSPLANT IN CHILDREN WITH BILIARY ATRESIA
Authors: GIBELLI, Nelson Elias MendesANDRADE, Wagner de CastroVELHOTE, Manoel Carlos PrietoAYOUB, Ali Abdul RahmanSILVA, Marcos Marques daPINHO-APEZZATO, Maria Lucia deTANNURI, Ana Cristina AounBARROS, Fabio deRICARDI, Luis Roberto SchlaichMOREIRA, Daniel de Albuquerque RangelMIYATANI, Helena ThiePEREIRA, Paulo Renato AlencarTANNURI, Uenis
Citation: PEDIATRIC TRANSPLANTATION, v.17, n.2, p.195-195, 2013
Abstract: BACKGROUND/PURPOSE: zPost transplant portal vein thrombosis (PVT)can be extremely disastrous, and portal hypertension and other consequences of the long term privation of portal inflow to the graft may be hazardous, especially in the very young children. Since 1998, Rex shunt has been used successfully to treat these patients. In 2007 we started to perform this surgery in patients with idiopathic PVT and late post transplant PVT. We report our experience with this technique in acute post transplant PVT. METHODS: Case report of six patients (age–12–18 months) submitted to cadaveric (1) and living donor (5) liver transplant (LT). All patients had biliary atresia with portal vein hipoplasia and developed acute portal vein thrombosis (PVT) in the first post-operative day. They were submitted to a mesenteric-portal surgical shunt (Rex shunt) with left internal jugular vein autograft (5) and cadaveric iliac vein graft (1) in the first post-operative day. RESULTS: Current follow-up of 12 months. Postoperative Doppler ultrasounds confirmed shunt patency. There were no biliary complications until now. CONCLUSION: The mesenteric-portal shunt (Rex shunt) with left internal jugular vein autograft should be considered in children with acute PVT after liver transplantation. These children usually have small portal veins, and reanastomosis is often unsuccessful. In addition, this technique has the advantage that we do not manipulate the biliary anastomosis and the hepatic hilum, thus avoiding biliary complications. Although this is an initial experience, we conclude that this technique is feasible, with great benefits for these patients and with low risks.
Appears in Collections:

Comunicações em Eventos - FM/MCG
Departamento de Cirurgia - FM/MCG

Comunicações em Eventos - FM/MPE
Departamento de Pediatria - FM/MPE

Comunicações em Eventos - HC/ICr
Instituto da Criança - HC/ICr

Comunicações em Eventos - LIM/26
LIM/26 - Laboratório de Pesquisa em Cirurgia Experimental

Comunicações em Eventos - LIM/30
LIM/30 - Laboratório de Investigação em Cirurgia Pediátrica


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