A surgical technique for portal vein decompression in retransplantation

Liver retransplantation is the only option for people who have a failing liver graft, but it can be technically challenging. Intraperitoneal adhesions often form after abdominal operations, which is true in liver retransplantation as well. Also, the liver hilum is scarred, which makes hilar dissection more difficult. In addition, dissection is further complicated in the setting of portal hypertension.

Venovenous bypass can be used for portomesenteric decompression. We describe an alternative technique for decompression of portal hypertension using an inferior mesenteric vein without placing the patient on venovenous bypass.