Portal vein reconstruction in adult living donor liver transplantation for patients with portal vein thrombosis in single center experience

Journal of Hepato-biliary-pancreatic Sciences
Akira MoriShinji Uemoto

Abstract

Liver transplantation (LT) used to be contraindicated in patients with portal vein thrombosis (PVT). In comparison to deceased donor LT, living donor LT (LDLT) still presents additional difficulties in determining appropriate vein grafts and overcoming small-for-size syndrome. Here, we introduce our LDLT strategies and assess their outcomes in adult patients with pre-existing PVT. We performed 282 consecutive adult LDLTs between April 2006 and December 2011. Forty-eight patients (17%) had pre-existing PVT (grade I; 15, II; 20, III; 12, IV; 1). Our preferred treatments for PVT were thrombectomies/thromboendovenectomies in 30 patients, replaced grafts in seven, jump grafts in seven, renoportal anastomosis in one and no surgical intervention owing to minimal thrombosis in three. Post-transplant portal vein complications occurred in eight of 48 (17%) cases, which were treated by surgery, anticoagulation therapy, and/or interventional radiology. Post-transplant survival rates of patients with preexisting PVT at 1 year and 5 years were comparable to a PVT-free cohort (1 year; 81% vs. 77%, 5 years; 81% vs. 73%). The excellent survival rates in patients with PVT who underwent LDLT could be attributed to our strategies, which included s...Continue Reading

References

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Citations

Nov 6, 2015·Gastroenterology Research and Practice·Cristian LupascuJan Lerut
Dec 20, 2015·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Hui ChenJuan Carlos Garcia-Pagán
Jan 24, 2017·Pediatric Transplantation·Tarek Abdelazeem SabraShinji Uemoto
Oct 27, 2018·Transplant International : Official Journal of the European Society for Organ Transplantation·Giuseppe D'AmicoCristiano Quintini
Aug 14, 2019·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Toru IkegamiMasaki Mori
Dec 16, 2019·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Toru IkegamiMasaki Mori
Jan 17, 2020·Journal of Hepato-biliary-pancreatic Sciences·Jinsoo RhuJae-Won Joh
Jul 25, 2018·World Journal of Gastroenterology : WJG·Lesley De PietriMarco Vivarelli
Jul 25, 2018·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Mohamed Abdel WahabRami Said
Aug 21, 2021·Hepatobiliary & Pancreatic Diseases International : HBPD INT·Guo-Ling LinShu-Sen Zheng

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