title: Clinical analysis of living donor liver transplantation in patients with portal vein thrombosis.
abstract: The aim of this study was to improve outcomes in living donor liver transplantation (LDLT) patients with portal vein thrombosis (PVT). Of 246 adult patients who underwent LDLT with a right lobe graft between January 2000 and May 2007, PVT was diagnosed in 50 patients (20.3%), who were further subdivided into partial (n = 39, 78%) and complete (n = 11, 22%) types. Patients with PVT, especially complete PVT, showed high incidences of variceal bleeding (p = 0.021), operative RBC transfusion (p < 0.046) and a post-transplantation complications related to bleeding (p = 0.058). We also classified PVT according to its location and the presence of collaterals: type I (n = 41, 82%): PVT localized above the confluence of the splenic and superior mesenteric veins (SMV); type II (n = 7, 14%): PVT extending below the confluence with a patent distal SMV; type III (n = 2, 4%): complete portal vein and SMV thrombosis except for a coronary vein. LDLT could be safely undertaken in patients with PVT without increased mortality. In our type II and III PVT, when thrombectomy fails, jump grafting using a cryopreserved vessel may serve as a reliable alternative method to restore portal flow.
authors.affiliation: Department of Surgery, The Catholic University of Korea, Seocho-Goo, Seoul, Korea.
authors.forename: Say-June
authors.initials: SJ
authors.lastname: Kim
authors.forename: Dong-Goo
authors.initials: DG
authors.lastname: Kim
authors.forename: Jung-Hyun
authors.initials: JH
authors.lastname: Park
authors.forename: In-Sung
authors.initials: IS
authors.lastname: Moon
authors.forename: Myung-Duk
authors.initials: MD
authors.lastname: Lee
authors.forename: Ji-Il
authors.initials: JI
authors.lastname: Kim
authors.forename: Young-Chul
authors.initials: YC
authors.lastname: Yoon
authors.forename: Young-Kyung
authors.initials: YK
authors.lastname: Yoo
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008111:Liver Function Tests; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000601:surgery*; D011182:Postoperative Care; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D017131:Thrombectomy; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000601:surgery*; D055815:Young Adult