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Updated: Jun 26, 2026
16:19
Heterotopic Auxiliary Rat Liver Transplantation With Flow-regulated Portal Vein Arterialization in Acute Hepatic Failure
Published on: September 13, 2014
Reverse portal flow after liver transplantation--ominous or acceptable?
V S Jones1, J L McCall, G Thomas
1Department of Surgery, Children's Hospital at Westmead, Westmead, Sydney, NSW, Australia. vincijones@yahoo.co.in
Pediatric Transplantation
|January 30, 2009
Summary
Hepatofugal flow after liver transplant is rare but not always fatal. Non-operative treatment with immunosuppression led to spontaneous recovery in two pediatric patients, challenging previous survival assumptions.
Area of Science:
- Hepatology
- Transplant Surgery
- Pediatric Gastroenterology
Background:
- Reversal of portal flow (hepatofugal flow) post-liver transplantation is a rare and historically ominous complication.
- Literature suggests this condition necessitates immediate surgical intervention for a favorable prognosis.
Observation:
- Two pediatric liver transplant recipients developed hepatofugal flow in the early postoperative period.
- Potential causes identified were acute rejection in one case and absent middle hepatic vein (MHV) leading to inadequate venous outflow in the other.
Findings:
- Both patients were successfully managed non-operatively with enhanced immunosuppression and steroid therapy.
- Spontaneous normalization of portal flow (hepatopetal) occurred in both cases, with patients remaining well at six months post-transplant.
Implications:
- This case series challenges the dogma that hepatofugal flow invariably indicates a grim prognosis without surgical intervention.
- Further research is needed to identify specific patient criteria that may benefit from surgical versus non-operative management of post-transplant hepatofugal flow.
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