title: Successful minimally invasive management of late portal vein thrombosis after splenectomy due to splenic artery steal syndrome following liver transplantation: a case report.
abstract: 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.
authors.affiliation: Department of Surgery and Transplantation Unit, University of Udine, Udine, Italy. mauricio.sainz@wanadoo.es
authors.forename: M
authors.initials: M
authors.lastname: Sainz-Barriga
authors.forename: U
authors.initials: U
authors.lastname: Baccarani
authors.forename: A
authors.initials: A
authors.lastname: Risaliti
authors.forename: D
authors.initials: D
authors.lastname: Gasparini
authors.forename: M
authors.initials: M
authors.lastname: Sponza
authors.forename: G L
authors.initials: GL
authors.lastname: Adani
authors.forename: P L
authors.initials: PL
authors.lastname: Toniutto
authors.forename: C
authors.initials: C
authors.lastname: Avellini
authors.forename: G
authors.initials: G
authors.lastname: Ramacciato
authors.forename: F
authors.initials: F
authors.lastname: Bresadola
mesh_terms: 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