Original contributions: Case reportsLiverLiver Transplantation in an Adult Recipient With Situs Inversus Totalis: Case Report and Review of the Literature

•The expansion of LGLs after allo-SCT is usually donor-derived.•We report a case of LGF associated with the expansion of recipient-derived T-LGL.•The expansion of recipient-derived T-LGLs after allo-SCT can be a sign of graft rejection.

BackgroundOver the past few decades, reports have demonstrated the feasibility of liver transplantation in adult patients with situs inversus. However, this disease entity remains rare and experience remains limited in adult recipients with situs inversus undergoing transplantation.MethodsA 23-year-old woman with situs inversus totalis and end-stage liver disease secondary to congenital biliary atresia was referred to our center and underwent a successful orthotopic liver transplantation.ResultsWe report our experience and review the literature. We performed a modified piggy-back technique with cavo-cavostomy. Using a triangulated wide orifice, the suprahepatic cava was anastomosed in an end-to-side fashion. The patient underwent an uneventful hospitalization and recovery.ConclusionSitus inversus remains a rare condition. Careful perioperative planning, thorough anatomic knowledge of both donor and recipient liver, and use of a variety of different novel techniques can lead to successful outcomes.