Portal vein thrombosis in liver transplantation.
In the initial experience of liver transplantation, complete thrombosis and portal vein occlusion were considered to be absolute contraindications for liver transplantation. The incidence of portal thrombosis in patients being prepared for transplantation varies between 5% and 15% according to published series. There are 2 surgical techniques to solve absent or low portal vein flow due to thrombosis. The most widely used technique is thrombectomy and the second technique is insertion of a shunt with a venous graft in the permeable portion of the superior mesenteric vein or in a vein in the splanchnic territory. Portal thrombosis recurrence rates vary among series, ranging from 0% to 25% or even 30%, depending on its extension and severity and also on time the transplantation was performed. Although overall survival is somewhat lower, there are no significant differences in most of the series when patients with portal thrombosis who underwent transplantation are compared with those without.
Charco
R
R
Liver Transplantation Unit, IMDiM, Hospital Clinic i Provincial, Barcelona, Spain. rcharco@clinic.ub.es
Fuster
J
J
Fondevila
C
C
Ferrer
J
J
Mans
E
E
García-Valdecasas
J C
JC
D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000473:pathology*; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D012008:Recurrence; D013927:Thrombosis / Q000145:classification / Q000209:etiology* / Q000601:surgery; D014463:Ultrasonography