Prevention and treatment of rethrombosis after liver transplantation with an implantable pump of the portal vein.
Implantable pumps have been used to prevent deep vein thrombosis and other diseases. In this article, we report for the first time the prevention and treatment of rethrombosis of the portal vein in liver transplantation with an implantable pump of the portal vein. Four hundred four orthotopic liver transplantation cases were retrospectively reviewed and divided into 3 groups: portal vein thrombosis (PVT) patients with an implantable pump (n = 28), PVT patients without an implantable pump (n = 20), and patients without preexisting PVT (n = 356). The following parameters for the 3 groups of patients were calculated and compared: (1) preoperative parameters, including baseline data of the donors and recipients and times of graft ischemia; (2) intraoperative and postoperative parameters, including surgery time, red blood cell and plasma transfusion, platelet concentrate transfusion, bleeding and primary graft malfunction, and duration of the hospital and intensive care unit stays; and (3) follow-up information for the patency of the portal vein, rethrombosis rate, stenosis and reoperation (relaparotomy or retransplantation), in-hospital mortality, and actuarial 1-year survival rate. Among the 3 groups of recipients, no significant differences were detected in preoperative and intraoperative parameters. However, compared to PVT patients without an implantable pump, PVT patients with an implantable pump showed remarkable reductions in their postoperative hospital stay, rethrombosis, reoperation rate, and in-hospital mortality. An implantable pump of the portal vein in liver transplantation patients can prevent and facilitate the treatment of portal vein rethrombosis and is associated with a reduction of in-hospital mortality.
Shi
Zhengrong
Z
Liver Transplantation Division, Department of Surgery, West China Hospital, Sichuan University, Chengdu, China.
Yan
Lunan
L
Zhao
Jichun
J
Li
Bo
B
Wen
Tianfu
T
Xu
Mingqing
M
Wang
Wentao
W
Chen
Zheyu
Z
Yang
Jiaying
J
D000328:Adult; D005260:Female; D006801:Humans; D015918:Infusion Pumps, Implantable; D016031:Liver Transplantation; D008297:Male; D011169:Portal Vein / Q000502:physiology*; D011379:Prognosis; D012039:Regional Blood Flow / Q000502:physiology; D012189:Retrospective Studies; D055502:Secondary Prevention; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000517:prevention & control*