[Liver transplantation with cavoportal or renoportal anastomosis: a solution in cases of diffuse portal thrombosis].
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.


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.


CONCLUSIONS
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.
Azoulay
Daniel
D
Centre Hépato-Biliaire, UPRES 1596, IFR 89.9, Hôpital Paul Brousse, Villejuif Université Paris-Sud, Paris, France. daniel.azoulay@pbr.ap-hop-paris.fr
Adam
René
R
Castaing
Denis
D
Muresan
Sorin
S
Essomba
Achile
A
Vibert
Eric
E
Savier
Eric
E
Smail
Alaoua
A
Veilhan
Luc-Antoine
LA
Bismuth
Henri
H
D000328:Adult; D005260:Female; D006801:Humans; D007677:Kidney Function Tests; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011167:Portacaval Shunt, Surgical; D011169:Portal Vein / Q000637:transplantation; D015424:Reperfusion; D020246:Venous Thrombosis / Q000150:complications
Transplantation hépatique avec anastomose cavo-porte ou réno-porte.