Successful minimally invasive management of late portal vein thrombosis after splenectomy due to splenic artery steal syndrome following liver transplantation: a case report.
Portal vein thrombosis (PVT) after liver transplantation (OLT), which occurs in 1% to 2.7% of cases, can compromise patient and graft survival. Percutaneous transhepatic portal vein angioplasty offers an option to treat PVT, diminishing surgically related morbidity and the need for retransplantation. We describe a case of late PVT after OLT, which was successfully treated by a minimally invasive percutaneous transhepatic approach using both mechanical fragmentation and pharmacologic lysis of the thrombus followed by anticoagulation. The patient has had a good clinical course with normal graft function and patent portal blood flow at 6-month follow-up. This case report confirms the possibility of successful recanalization of the portal vein in a patient with late PVT after liver transplantation. Sustained anticoagulation/antiaggregation therapy for at least 6 months after the procedure is advisable.
Sainz-Barriga
M
M
Department of Surgery and Transplantation Unit, University of Udine, Udine, Italy. mauricio.sainz@wanadoo.es
Baccarani
U
U
Risaliti
A
A
Gasparini
D
D
Sponza
M
M
Adani
G L
GL
Toniutto
P L
PL
Avellini
C
C
Ramacciato
G
G
Bresadola
F
F
D001157:Arterial Occlusive Diseases / Q000601:surgery*; D005260:Female; D006509:Hepatitis B / Q000150:complications / Q000601:surgery*; D003699:Hepatitis D / Q000150:complications / Q000601:surgery*; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008875:Middle Aged; D011169:Portal Vein; D013156:Splenectomy; D013157:Splenic Artery; D013927:Thrombosis / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome