چکیده (انگلیسی):

Liver transplantation is a standard treatment for patients with familial amyloidotic
polyneuropathy (FAP) with disease progression. Given the multiorgan involvement by
amyloidosis, the heart is often involved. When poor cardiac function becomes prohibitive to
liver transplantation, a combined heart-liver transplantation (CHLT) is the only realistic
treatment. This article records a CHLT for a patient with FAP whose removed liver was
immediately transplanted as an amyloidotic hepatic allograft (AHA) to a patient having
hepatocellular carcinoma and cirrhosis in a sequential liver transplantation. In the CHLT, the
heart and liver are donated by a deceased donor. The newly implanted heart did not tolerate
cross clamping of the inferior vena cava (IVC), so a side-to-side anastomosis was performed to
connect the IVC and that of the liver graft. Therefore, the AHA was devoid of an IVC. The
infrarenal cava procured from the deceased donor was used for reconstruction of the AHA
to match a whole graft used in routine deceased-donor liver transplantation. Venoplasty
was performed using the graft right hepatic vein and the middle and left hepatic vein stump
to form a single cuff. The reconstructed AHA was implanted to the recipient conveniently like
a usual whole graft.