%0 Journal Article
%T Liver Transplantation Using a Graft from a Donor with Situs Inversus Totalis: A Case Report and Review of the Literature
%A Xu-Yong Sun
%A Ke Qin
%A Jian-Hui Dong
%A Hai-Bin Li
%A Liu-Gen Lan
%A Ying Huang
%A Song Cao
%A Zhuang-Jiang Li
%J Case Reports in Transplantation
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/532865
%X It is critical to effectively use every available organ to meet the increasing demands for liver transplantation. Situs inversus is a rare congenital anomaly caused by obstruction of viscus rotation during embryonic development. Situs inversus was once regarded as a contraindication to liver transplantation because of the technical difficulties associated with the unique vascular anatomy and concern about achieving accurate graft positioning. Here, we present a successful case of liver transplantation using a graft from a donor with situs inversus totalis. The related experience will contribute to opening up new realms for the use of such rare organ resources. 1. Introduction Situs inversus is a rare congenital anomaly caused by obstruction of viscus rotation during embryonic development. Its incidence is about 0.01% worldwide. The viscus distribution in the situs inversus individuals is opposite to ordinary people. All thoracoabdominal organs and retroperitoneal organs (i.e., kidneys and adrenal glands) are symmetrically positioned to the midline, which is often called mirror-image reversal [1]. Situs inversus was once regarded as a contraindication to liver transplantation because of the technical difficulties associated with the unique vascular anatomy and concern about achieving accurate graft positioning [2, 3]. For a number of patients with situs inversus, liver transplantation has been successfully performed during the last two decades [4¨C8]. However, few cases of deceased donor organs with situs inversus used for liver transplantation have been reported [3, 9¨C11]. Here, we present a case of liver transplantation using a graft from a donor with situs inversus totalis. 2. Case Report A 23-year-old male was referred to our hospital in May 2008 due to severe traumatic brain injury caused by a traffic accident and was diagnosed as brain dead shortly after admission. Dextrocardia was found during physical examination and situs inversus totalis was verified by further X-ray and ultrasonic inspection. During the retrieval of donor organs, it was found that the liver, pancreas, and stomach were located in the opposite positions. The descending aorta was located directly in front of the spine and the inferior vena cava was found in the front left of the spine. Organ procurement was smoothly performed without great difficulty even though the procedure took a little longer due to the operatorĄ¯s habitual thinking about the anatomy. During preparation of the donated liver, the anatomical relations were clearly identified, that is, liver artery locating in
%U http://www.hindawi.com/journals/crit/2013/532865/