Abstract:

A male patient, 53 years old, suffered from hepatitis B over 20 years and underwent right posterior lobe hepatectomy for primary liver cancer at General Hospital of Chinese PLA, followed by twice liver intervention therapy. On April 28th, 2004, the patient received recurrent tumor resection attached splenectomy and ligation of pericardial vein for hepatic cirrhosis portal hypertension at Yuhuangding Hospital, Qingdao University Medical College. After 14 months, the patient was admitted and received a liver transplantation for recurrent tumor. During operation, diffuse thrombosis was found in portal and mesenteric venous and pathological report of fast frozen section showed organized thrombus. A liver transplantation was performed by applying a cavoportal hemitransposition technique rather than orthotopic liver transplantation. The patient was discharged from hospital after 30 days. After 170 days postoperatively, hemorrhage occurred 5 times successively accompanied with hematemesis, tarry stools and hemorrhagic shock. The patient survived 14 months and died from metastatic carcinoma of the brain and lung. Results show that the modified cavoportal hemitransposition technique and using the donor iliac vein to act as a bridge between the donor portal vein and host superior mesenteric vein in liver transplantation is effective as a salvage measure for preventing hemorrhage of digestive tract. In addition, protocol anticoagulant therapy for preventing portal thrombosis is essential for the patients received splenectomy and ligation of pericardial vein, which provide conditions for liver transplantation and improve life quality of patients.