Clinical analysis of living donor liver transplantation in patients with portal vein thrombosis.

Abstract:

:The aim of this study was to improve outcomes in living donor liver transplantation (LDLT) patients with portal vein thrombosis (PVT). Of 246 adult patients who underwent LDLT with a right lobe graft between January 2000 and May 2007, PVT was diagnosed in 50 patients (20.3%), who were further subdivided into partial (n = 39, 78%) and complete (n = 11, 22%) types. Patients with PVT, especially complete PVT, showed high incidences of variceal bleeding (p = 0.021), operative RBC transfusion (p < 0.046) and a post-transplantation complications related to bleeding (p = 0.058). We also classified PVT according to its location and the presence of collaterals: type I (n = 41, 82%): PVT localized above the confluence of the splenic and superior mesenteric veins (SMV); type II (n = 7, 14%): PVT extending below the confluence with a patent distal SMV; type III (n = 2, 4%): complete portal vein and SMV thrombosis except for a coronary vein. LDLT could be safely undertaken in patients with PVT without increased mortality. In our type II and III PVT, when thrombectomy fails, jump grafting using a cryopreserved vessel may serve as a reliable alternative method to restore portal flow.

journal_name

Clin Transplant

journal_title

Clinical transplantation

authors

Kim SJ,Kim DG,Park JH,Moon IS,Lee MD,Kim JI,Yoon YC,Yoo YK

doi

10.1111/j.1399-0012.2010.01217.x

subject

Has Abstract

pub_date

2011-01-01 00:00:00

pages

111-8

issue

1

eissn

0902-0063

issn

1399-0012

pii

CTR1217

journal_volume

25

pub_type

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