LIVER-TRANSPLANTATION IN PATIENTS WITH SITUS-INVERSUS

Seven patients with situs inversus abdominis and one with situs invers us totalis underwent liver transplantation; all are alive at follow-up of between 7 months and 5 years. Two patients required retransplantat ion within the first 3 weeks (for primary non-function and thrombotic infarction). Seven had additional abnormalities associated with the po lysplenia-biliary atresia syndrome. Liver transplantation in these pat ients involved selection of relatively small donor organs or use of re duced-sized grafts. Delay abdominal wall closure was necessary in two patients and all required a modification of the 'piggy-back' technique of suprahepatic vena caval anastomosis to overcome recipient venous a nomalies. Biliary drainage by Roux-en-Y choledochojejunostomy was the preferred technique. Although technically challenging, situ inversus i s not a contraindication to liver transplantation and patients should expect full recovery.