OBJECTIVE: Liver transplantation was contraindicated in patients with diffuse thrombosis of the portal vein until the recent use of graft portal vein reperfusion with the caval flow or one of its tributaries. Long term results of these procedures are reported here. PATIENTS AND METHODS: Eight patients with diffuse portal vein thrombosis were transplanted by portal reperfusion via latero-terminal anastomosis between the native caval vein and the graft portal vein (2 patients) or termino-terminal between the native left renal vein and the graft portal vein (6 patients). RESULTS: Three patients died 3, 3 and 6 months following transplantation from intracerebral hemorrhage, cardiac arrest, and chronic rejection respectively. Three patients had complicated portal hypertension. Five patients were alive at home with a median follow-up of 9 months (2 to 37 months) with normal liver and kinase functions. CONCLUSION: Portal reperfusion with the caval vein flow allows transplantation of patients with diffuse poral vein thrombosis. According to our experience and to the analysis of the literature, reno-portal anastomosis is preferable to cavo-portal reconstruction.
OBJECTIVE: Liver transplantation was contraindicated in patients with diffuse thrombosis of the portal vein until the recent use of graft portal vein reperfusion with the caval flow or one of its tributaries. Long term results of these procedures are reported here. PATIENTS AND METHODS: Eight patients with diffuse portal vein thrombosis were transplanted by portal reperfusion via latero-terminal anastomosis between the native caval vein and the graft portal vein (2 patients) or termino-terminal between the native left renal vein and the graft portal vein (6 patients). RESULTS: Three patients died 3, 3 and 6 months following transplantation from intracerebral hemorrhage, cardiac arrest, and chronic rejection respectively. Three patients had complicated portal hypertension. Five patients were alive at home with a median follow-up of 9 months (2 to 37 months) with normal liver and kinase functions. CONCLUSION: Portal reperfusion with the caval vein flow allows transplantation of patients with diffuse poral vein thrombosis. According to our experience and to the analysis of the literature, reno-portal anastomosis is preferable to cavo-portal reconstruction.
Authors: J Lendoire; G Raffin; N Cejas; F Duek; P Barros Schelotto; P Trigo; C Quarin; V Garay; O Imventarza Journal: HPB (Oxford) Date: 2007 Impact factor: 3.647