New Surgical Approach to Large Splenorenal Shunt in Living Donor Liver Transplantation: Diversion of SMV and SPV Blood Flow

Introduction: The management of a large splenorenal shunt is important because it affects recipient outcome, particularly in living donor liver transplantation. Methods: To manage large splenorenal shunts in living donor liver transplantation, we diverted superior mesenteric vein and splenic portal vein blood flow by ligation at the root of the splenic portal vein. Result: This procedure was applied for five patients in whom superior mesenteric vein blood flow had been completely stolen by a splenorenal shunt preoperatively. Postoperative course was excellent in all cases. Conclusion: This technique completely prevents morbidity related to large splenorenal shunts after living donor liver transplantation.