TITLE:
Gastric Volvulus Complicates the Hepatectomy for Living Donor Liver Transplantation
AUTHORS:
Reinaldo Fernandes, Marcelo Enne, Klaus Steinbruck, José Manoel Martinho, Rafael Vasconcelos, Gustavo Stoduto, Lúcio Filgueiras Pacheco-Moreira
KEYWORDS:
Living Donors; Hepatectomy; Postoperative Complications; Liver Transplantation; Gastric Volvulus
JOURNAL NAME:
Open Journal of Organ Transplant Surgery,
Vol.2 No.4,
November
6,
2012
ABSTRACT: Donor safety is the major concern in living donor liver transplantation (LDLT), and a constant aware of postoperative morbidity should be emphasized. Between March 2002 and May 2011 we performed 435 liver transplantations at an our center, one hundred forty eight with living donors. Among them left lobectomy or left lateral resections were conducted in 68 cases. Symptoms of gastric obstruction were recognized in 3 out of 68 patients that underwent left lateral resection (4.4%). The patients were readmitted because of severe symptoms of vomiting and abdominal pain. An upper endoscopy was performed and revealed pyloroantral obstruction due to gastric volvulus (GV). Endoscopic therapy correction was successfully performed in all patients. Reviewing the literature, one article has reported GV in 13 out of 115 donors (11.3%), all patients were submitted to a left resection. The mechanisms underlying this complication, in LDLT scenario, have not been fully elucidated. Nevertheless, clinicians should be aware of this possible association, which could make the diagnosis of GV more likely if a living donor comes back with typical symptoms.