Multivisceral transplantation refers to en-bloc transplantation of the liver, stomach, pancreaticoduodenal complex as well as the small bowel, sometimes also including a kidney. Some authors, however, call it a multivisceral transplant if the stomach, pancreas and intestine are transplanted together without the liver. Exenteration of all native viscera which must precede the multivisceral transplants can be technically demanding in patients with portal hypertension due to diffuse splanchnic thrombosis or with severe adhesions after multiple laparotomies. Multivisceral transplantation is performed in patients with either diffuse thrombosis of all splanchnic veins usually associated with coagulation abnormalities, desmoid tumors involving the vascular supply of the liver, pancreas and intestines, or severe motility disorders.
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