title: Outcome of patients with pre-existing portal vein thrombosis undergoing arterialization of the portal vein during liver transplantation.
abstract: Arterialization of the portal vein is being propagated as a technical possibility in liver transplant recipients with pre-existing portal vein thrombosis. In our own small series, portal vein arterialization (PVA) was carried out in four patients undergoing orthotopic liver transplantation. In three of these cases, the portal vein was anastomosed to the aorta via an interposed iliac artery, and in one case, directly to the hepatic artery. After PVA, all transplants showed regular initial function. Two patients died postoperatively after 19 and 50 days, of intra-abdominal haemorrhage and liver necrosis with thrombosis of the portal vein, respectively. A further patient had previously developed fibrosis of the liver, which led to the death of the patient 11 months after PVA. In the remaining patient, chronic rejection requiring re-transplantation developed 24 months after PVA had been performed. These unfavourable results prompt the conclusion that PVA cannot be recommended as a standard clinical procedure.
authors.affiliation: Department of Surgery, University of Leipzig, Liebigstrasse 20a, 04103 Leipzig, Germany. ottr@medizin.uni-leipzig.de
authors.forename: Rudolf
authors.initials: R
authors.lastname: Ott
authors.forename: Cathrin
authors.initials: C
authors.lastname: Böhner
authors.forename: Susanna
authors.initials: S
authors.lastname: Müller
authors.forename: Thomas
authors.initials: T
authors.lastname: Aigner
authors.forename: Michaela
authors.initials: M
authors.lastname: Bussenius-Kammerer
authors.forename: Suleyman
authors.initials: S
authors.lastname: Yedibela
authors.forename: Hermann
authors.initials: H
authors.lastname: Kissler
authors.forename: Werner
authors.initials: W
authors.lastname: Hohenberger
authors.forename: Thomas
authors.initials: T
authors.lastname: Reck
authors.forename: Volker
authors.initials: V
authors.lastname: Müller
mesh_terms: D000328:Adult; D000368:Aged; D001011:Aorta / Q000601:surgery; D001166:Arteriovenous Shunt, Surgical / Q000379:methods*; D006509:Hepatitis B / Q000175:diagnosis; D006801:Humans; D007083:Iliac Artery / Q000637:transplantation; D017093:Liver Failure / Q000150:complications / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods*; D008875:Middle Aged; D011169:Portal Vein / Q000601:surgery*; D011183:Postoperative Complications / Q000401:mortality / Q000821:virology; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000150:complications / Q000601:surgery*