OBJECTIVE: To investigate the outcome of liver transplantation(LT) for end stage liver disease with portal vein thrombosis (PVT) in different processes. METHODS: Data from 308 patients who underwent LT from July 2004 to February 2008 were retrospectively assessed. The processes of varies grades of PVT during LT were analyzed and estimated for whether the outcome of LT was different between patients with or without PVT. RESULTS: There were 46 patients with PVT, including 11 of grade 1, 14 of grade 2, 18 of grade 3 and 3 of grade 4. LT performed in grade 1 and 2 PVT patients without special intervention. LT was performed in 16 patients with grade 3 PVT after simple thrombectomy or thrombus-extraction. The other 2 patients with grade 3 PVT received the donor superior mesenteric vein to act as a bridge between the donor portal vein and host superior mesenteric vein. Two cases with grade 4 PVT received a cavo-portal hemitransposition, and the other one anastomosis between graft portal vein and varicose coronary vein. The postoperative 1-year survival rates of patients without PVT and patients with PVT were 91.6%(240/262), 80.5%(211/262)vs 86.9%(40/46), 76.1%(35/46), respectively. The patients with PVT had a recurrence rate of 4.3%(2/46). CONCLUSION: Most patients suffering from end stage liver disease with PVT can be successfully treated by LT. However, the result of the patients with diffused PVT undergoing LT is relatively poor.
OBJECTIVE: To investigate the outcome of liver transplantation(LT) for end stage liver disease with portal vein thrombosis (PVT) in different processes. METHODS: Data from 308 patients who underwent LT from July 2004 to February 2008 were retrospectively assessed. The processes of varies grades of PVT during LT were analyzed and estimated for whether the outcome of LT was different between patients with or without PVT. RESULTS: There were 46 patients with PVT, including 11 of grade 1, 14 of grade 2, 18 of grade 3 and 3 of grade 4. LT performed in grade 1 and 2 PVT patients without special intervention. LT was performed in 16 patients with grade 3 PVT after simple thrombectomy or thrombus-extraction. The other 2 patients with grade 3 PVT received the donor superior mesenteric vein to act as a bridge between the donor portal vein and host superior mesenteric vein. Two cases with grade 4 PVT received a cavo-portal hemitransposition, and the other one anastomosis between graft portal vein and varicose coronary vein. The postoperative 1-year survival rates of patients without PVT and patients with PVT were 91.6%(240/262), 80.5%(211/262)vs 86.9%(40/46), 76.1%(35/46), respectively. The patients with PVT had a recurrence rate of 4.3%(2/46). CONCLUSION: Most patients suffering from end stage liver disease with PVT can be successfully treated by LT. However, the result of the patients with diffused PVT undergoing LT is relatively poor.
Authors: Francesca R Ponziani; Maria A Zocco; Chiara Campanale; Emanuele Rinninella; Annalisa Tortora; Luca Di Maurizio; Giuseppe Bombardieri; Raimondo De Cristofaro; Anna M De Gaetano; Raffaele Landolfi; Antonio Gasbarrini Journal: World J Gastroenterol Date: 2010-01-14 Impact factor: 5.742