Clinical analysis of living donor liver transplantation in patients with portal vein thrombosis.
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.
Kim
Say-June
SJ
Department of Surgery, The Catholic University of Korea, Seocho-Goo, Seoul, Korea.
Kim
Dong-Goo
DG
Park
Jung-Hyun
JH
Moon
In-Sung
IS
Lee
Myung-Duk
MD
Kim
Ji-Il
JI
Yoon
Young-Chul
YC
Yoo
Young-Kyung
YK
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