Living-Related Liver Retransplantation in a Child: When it Seems Impossible (A Clinical Case)

The objective: to show the possibility of anesthesia during liver retransplantation in a child absence adequate vascular access. A clinical case 10-year-old patient with transplant dysfunction and acquired thrombophilia is considered. In 2011, underwent Kasai portoenterostomy, 2012, living-related transplantation left lateral bisegment from related donor was performed due cirrhosis as an outcome biliary atresia. Also, had multiple surgical interventions perforations small intestine underlying segmental venous mesenteric thrombosis. long term after transplantation, irreversible developed manifestations worsening hepatocellular insufficiency, encephalopathy, well recurrent bleeding varicose veins esophagus cardiac orifice. situation complicated by lack access total thrombosis system, superior inferior vena cava. only possible option for ensuring implantation tunneled catheter into right atrium prolonged standing conditions single-lung ventilation through right-sided thoracotomy.