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Portal vein reconstruction in adult living donor liver transplantation for patients with portal vein thrombosis in single center experience
Author(s) -
Mori Akira,
Iida Taku,
Iwasaki Junji,
Ogawa Kohei,
Fujimoto Yasuhiro,
Uemura Tadahiro,
Hatano Etsuro,
Okajima Hideaki,
Kaido Toshimi,
Uemoto Shinji
Publication year - 2015
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.235
Subject(s) - medicine , portal vein thrombosis , surgery , thrombosis , anastomosis , portal vein , liver transplantation , single center , vein , cohort , transplantation , live donor
Background 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. Methods 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). Results 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%). Conclusions The excellent survival rates in patients with PVT who underwent LDLT could be attributed to our strategies, which included surgical techniques and timely treatment of postoperative complications.