Liver transplantation in situs inversus

Background Patients with situs inversus needing liver transplantation are of particular interest because of the difficult technical problem presented. The rareness of this anatomical anomaly is associated with various congenital anomalies, and there is a lack of donors with situs inversus. Case outline An 18-year-old woman with situs inversus required liver transplantation for biliary cirrhosis secondary to extrahepatic cholestasis due to multiple calculi and choledochal cyst. Results Transplantation was performed, and the new liver was placed in a medial position next to the spine. The stomach (on the right) was attached to the diaphragm to act as a fixed base for the liver in order to prevent twisting of the caval anastomosis. The postoperative period was uneventful. Discussion When planning liver transplant in a patient with situs inversus, alignment of the liver over the spine plus fixation to the stomach and diaphragm is a rapid and safe procedure that permits an uncomplicated recovery.