Outcome of patients with pre-existing portal vein thrombosis undergoing arterialization of the portal vein during liver transplantation.
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.
Ott
Rudolf
R
Department of Surgery, University of Leipzig, Liebigstrasse 20a, 04103 Leipzig, Germany. ottr@medizin.uni-leipzig.de
Böhner
Cathrin
C
Müller
Susanna
S
Aigner
Thomas
T
Bussenius-Kammerer
Michaela
M
Yedibela
Suleyman
S
Kissler
Hermann
H
Hohenberger
Werner
W
Reck
Thomas
T
Müller
Volker
V
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*