Heterotaxy syndrome with malrotation of the gut and interrupted vena cava does not preclude safe procurement of multivisceral graft

Am J Transplant. 2014 Mar;14(3):724-8. doi: 10.1111/ajt.12627. Epub 2014 Feb 6.

Abstract

We report the first successful procurement and transplantation of a multivisceral graft from a pediatric donor with polysplenic heterotaxy syndrome, including intestinal malrotation, midline liver with left-sided gallbladder and an interrupted inferior vena cava with azygous continuation. Procurement of the graft presented a surgical challenge in the presence of above anomalies. Modified approach to standard organ procurement and minor technical adaptation enabled successful transplantation. In an era of severe organ shortage of pediatric multivisceral grafts, a valuable organ offer should not lightly be declined for reasons of anatomic imperfections that might be overcome.

Keywords: Donor selection; heterotaxy syndrome; interrupted inferior vena cava; intestinal malrotation; multivisceral transplantation; organ procurement.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abnormalities, Multiple
  • Child, Preschool
  • Gallbladder / abnormalities*
  • Gallbladder / pathology
  • Gallbladder / surgery
  • Gallbladder Diseases / pathology
  • Gallbladder Diseases / surgery*
  • Heterotaxy Syndrome / pathology
  • Heterotaxy Syndrome / surgery*
  • Humans
  • Infant
  • Intestines / abnormalities
  • Intestines / pathology
  • Intestines / surgery*
  • Organ Transplantation
  • Prognosis
  • Tissue Donors
  • Tomography, X-Ray Computed
  • Venae Cavae / abnormalities
  • Venae Cavae / pathology
  • Venae Cavae / surgery*
  • Viscera / surgery*

Supplementary concepts

  • Left-sided gallbladder