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Single center experience of 39 patients with preoperative portal vein thrombosis among 404 adult living donor liver transplantations
Author(s) -
Egawa Hiroto,
Tanaka Koichi,
Kasahara Mureo,
Takada Yasutsugu,
Oike Fumitaka,
Ogawa Kohei,
Sakamoto Seisuke,
Kozaki Koichi,
Taira Kaoru,
Ito Takashi
Publication year - 2006
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.20777
Subject(s) - medicine , portal vein thrombosis , superior mesenteric vein , surgery , liver transplantation , portal vein , thrombosis , single center , thrombus , splenic vein , hepatic encephalopathy , transplantation , radiology , cirrhosis , portal hypertension
Abstract Living donor liver transplantation (LDLT) for patients with portal vein thrombosis (PVT) involves technical difficulty. The aim of this research was to analyze their preoperative diagnosis of PVT, operative procedures, and postoperative courses of patients with preoperative PVT. Thirty‐nine patients of 404 adult patients (9.7%) undergoing LDLT in our hospital from 1996 June to 2004 December had PVT at their transplantation. Twenty‐nine patients had intractable ascites, 21 had gastrointestinal bleeding, and 18 had encephalopathy. The thrombus was located in the portal trunk in 23, in the portal trunk and superior mesenteric vein (SMV) in 7, and developed into the SMV and the splenic vein in 8. The occlusive grade was partial in 29, and complete in 10 patients. The thrombus was removed by a simple technique, and eversion and/or incision technique, or total removal of the portal vein (PV). The PV was reconstructed with the thrombectomized native PV, with an interposed vein graft, or porto‐caval hemitransposition. Advanced PVT had a significant impact on blood loss and hospital mortality. Three out of 10 patients with residual PVT required radiological and/or surgical intervention after transplantation. In conclusion, thorough planning is essential for a successful LDLT outcome for patients with preexisting PVT. Liver Transpl 12:1512–1518, 2006. © 2006 AASLD.