METHODOLOGY: In the three cases, the portal pressures increased beyond 30 cmH2O after living-related donor
liver transplantation, despite the right lobe graft, and these patients underwent
splenectomy. After
splenectomy, their portal pressures decreased below 25 cmH2O. The portal pressure underwent auxiliary orthotopic partial
liver transplantation due to the hypercitrullinemia and did not change after surgery (9.5 to 11.5 cmH2O). Interestingly, the
hyperbilirubinemia occurring after living-related donor
liver transplantation were as the primary result of direct
bilirubin except for the patient with
citrullinemia. The posttransplanted portal pressures were controlled below 25 cmH2O in all patients, with their peak serum total
bilirubin levels not exceeding 15 mg/dL, and the patients were discharged without major complications. Three patients underwent
splenectomy, and did not suffer from serious
infection. The reduction in excessive
portal hypertension after living-related donor
liver transplantation might prevent liver injury and post-transplant
hyperbilirubinemia.
CONCLUSIONS: