Contraindication of Left lobe liver transplant

Q) Absolute contraindication for left lobe LDLT is
A. Trifurcation of the portal vein
B. Bifurcation of portal vein in the right lobe of the liver
C. Aberrant right hepatic artery
D. Right Posterior duct draining into left hepatic duct


ANSWER

Trifurcation of portal vein is not a contraindication of  left lobe liver transplant  as we will get a single portal vein on the left side

9k= Contraindication of Left lobe liver transplant
Portal vein

Bifurcation of portal vein in right lobe does not matter because we are leaving the right lobe behind

Again right aberrant artery does not matter because that segment is left behind

Right post duct draining into left duct gives rise to two ducts on the left or a single duct which is quite high.

C3-4-FF3 Contraindication of Left lobe liver transplant
Right posterior duct to left

 

 

 

 

 

Selective Shunt

Q) A type of Selective shunt for portal hypertension is
A. PSRS (Proximal spleno renal shunt) 
B. Warren shunt
C. SSPCS (Side to side portocaval shunt) 
D. Mesocaval
 shunt

Answer  Q 78

Surgical decompression can be achieved with total or partial portal systemic shunts or by selection variceal decompression.

 Total shunts divert all the portal flow to the systemic circulation. Partial shunts maintain some portal flow to the liver. Selective shunts only decompress gastroesophageal varices and maintain portal hypertension and flow to the liver. Read on for answer...

Hepatic blood flow

Q. All are true regarding hepatic blood flow except
A. Liver has dual blood supply from portal vein and hepatic artery
B. 70% of liver oxygen comes from the hepatic artery
C. 70-80% of blood supply to the liver is from portal vein

d) Liver receives 25% of cardiac output

Answer for premium

The explanation discusses how much blood and oxygen goes through portal vein and hepatic artery to the liver

What is hepatic artery buffer response

 

Liver trauma

Q) All are true for blunt hepatic trauma except
A. Grade V liver injuries are associated with vascular avulsion
B. Hepatic packing is an expeditious method to control bleeding in blunt hepatic trauma
C. After damage control Surgery and hepatic packing, abdominal compartment syndrome can
happen in immediate postoperative period
D. Post conservative management, in the 3rd week anemia MC occurs due to subcapsular
hematoma rupture

Answer

HCC Cancer

Q) Which of the following is true about screening in hepatocellular carcinoma (HCC Cancer) 

a) Alpha feto protein should be done 6 monthly

b) Ultrasound abdomen should be done 6 monthly

c) Candidates for liver transplant should be screened every 3 months

d) Nodules more than 2 cm should be followed up  more regularly

Answer b

In a cirrhotic liver, hcc cancer  can develop any time and a stringent screening protocols  have  to be followed for early detection and timely treatment. Earlier ultrasound of liver and alpha feto protein were both used as tumor markers. However in 2009 Marrero et al demonstrated the suboptimal accuracy of AFP and after that it has been removed from the screening protocol and now only ultrasound is being done.

The screening recommendation is not for those patients with severe Read More ...