History Situs inversus is a uncommon congenital anomaly seen as a
History Situs inversus is a uncommon congenital anomaly seen as a the entire inversion of stomach and thoracic organs. biliary problem after his 1st liver organ transplantation from a situs solitus donor. Re-transplantation was performed using a graft liver from a likewise situs inversus donor. Although the blood type between donor and recipient was incompatible the post-operative outcome was excellent under proper prophylaxis to the antibody-mediated rejection. Conclusion To the best of our knowledge this is the first report of liver transplantation from situs inversus to WHI-P97 situs inversus in adult recipient. Liver transplantation using situs matching donor makes the procedure much easier at the surgical point of view which has a benefit of less potential surgical complications. Furthermore ABO-incompatibility is usually acceptable for donor allocation HMR in cases that both donor and recipient are situs inversus. Keywords: Liver transplantation Retransplantation Situs inversus Abo incompatible Background Situs inversus (SI) is WHI-P97 usually a rare congenital anomaly characterized by the complete inversion of thoracic and abdominal organs with an estimated incidence in humans about 0.025% to 0.005% live births . The exact etiology of this disorder is currently unknown although choromosomes involved in lateralization and polarity are thought to play an important role . SI may also be associated with other complex anomalies such as biliary atresia intestinal and vascular malformations . Furthermore implanting a mirror image liver is technically challenging because of the reversed position and orientation of the graft and hepatic vessels. Thus SI was previously considered an absolute contraindication for liver transplantation (LTx) until the first LTx in SI patient in 1988 . Since then several cases of WHI-P97 successful LTx concerning SI in either recipients or donors have been reported [2 4 However experiences are still very limited. Liver graft from SI donor still could be discarded from transplantation by some transplant surgeons due to anatomic concerns . The optimal choice for LTx in patients with SI is undoubtedly to receive a similar mirror image liver graft. Given the rare occurrence of SI current only 1 case of LTx from SI to SI was reported in a kid finding a living related graft . Right here we report an effective case of LTx from a SI donor to a grown-up SI receiver. Our case is certainly particular uncommon and exclusive because: 1. The individual required re-transplantation because of graft failure following the initial LTx from a standard WHI-P97 donor; 2. The complete graft through the donor with SI was implanted; 3. The ABO bloodstream type between recipient and donor was incompatible. Case display A 53-year-old man was described our medical center in Sept 2012 for re-transplantation because of severe biliary problem after the initial LTx. His blood vessels type “O” was. Complete SI without various other abnormalities was determined when he was an adolescent. Pursuing splenectomy and hepatectomy because of hemorrhage after hepatitis B related cirrhosis and hepatocellular carcinoma respectively he underwent LTx from a deceased donor with situs solitus due to tumor recurrence in 2005 on the Eastern Hepatobiliary Medical procedures Medical center Shanghai China. Since half of a full year after LTx he suffered shows of biliary problem characterized as jaundice and fever. Bile duct stents had been inserted many times. The full total bilirubin fluctuated between 70-200?μmol/L and it had been elevated to about 400?μmol/L before he was listed for re-transplantation. He previously severe WHI-P97 epidermis pruritus and sporadic small hepatic comma. The donor was a 32-year-old male who experienced brain damage in an automobile incident and was pronounced useless soon after entrance. Image studies demonstrated that he was situs reversus. His blood vessels type “B” was. Provided the organic situs match the donor liver graft was assigned to the recipient after that. No technical issues were encountered through the WHI-P97 procurement. The liver organ graft showed totally inverted framework but without vessel anomaly after trimming the surplus tissue on back again table.