title: Portal vein thrombosis and liver transplantation: evolution during 10 years of experience at the University of Bologna.
abstract: OBJECTIVE
  To evaluate the evolution of liver transplantation (LT) in cases with partial and total portal vein thrombosis (PVT).
  
  
  BACKGROUND
  Portal vein thrombosis and in particular total PVT are still surgically demanding conditions, which can exclude patients from LT or increase the postoperative complications after LT.
  
  
  METHODS
  We reviewed our 10-year experience (first era 1998–2002 and second era 2003–2008), comparing the outcome of patients with PVT to a group without PVT.
  
  
  RESULTS
  Among 889 LTs, we intraoperatively diagnosed 91 PVTs (10.2%):51 partial PVTs (56%) and 40 total PVTs (44%). The rate of complete PVTs increased from the first to the second era (2.2% vs. 6.7%, P < 0.005). Partial PVTs were mainly treated with thrombectomy while complete PVTs were managed with thrombectomy in 26 cases (63%), jumping graft in 6 (15%), portocaval hemitransposition in 6 (15%), and anastomosis to varix in 3 (7%). Among cases of PVT and no-PVT, the postoperative mortality was comparable (6.6% vs. 5.8%), as were the 1- and 5-year patient survival rates (85% and 68% PVT vs. 86% and 73% non-PVT). The postoperative outcome was similar in the PVT group between patients with partial and complete PVT, but in this last group, patient survival differed significantly between the 1st and 2nd era (57% vs. 89% at 1 year, P < 0.05).
  
  
  CONCLUSIONS
  Liver transplantation offers good survival in patients with partial PVT but also in selected cases with total PVT, where surgical innovation has improved the results.
authors.affiliation: Department of Surgery and Transplantation, Sant'Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 9, Bologna, Italy. mrava1@hotmail.com
authors.forename: Matteo
authors.initials: M
authors.lastname: Ravaioli
authors.forename: Matteo
authors.initials: M
authors.lastname: Zanello
authors.forename: Gian Luca
authors.initials: GL
authors.lastname: Grazi
authors.forename: Giorgio
authors.initials: G
authors.lastname: Ercolani
authors.forename: Matteo
authors.initials: M
authors.lastname: Cescon
authors.forename: Massimo
authors.initials: M
authors.lastname: Del Gaudio
authors.forename: Alessandro
authors.initials: A
authors.lastname: Cucchetti
authors.forename: Antonio Daniele
authors.initials: AD
authors.lastname: Pinna
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000601:surgery; D000075202:Contraindications; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000150:complications* / Q000401:mortality / Q000601:surgery; D008113:Liver Neoplasms / Q000150:complications / Q000601:surgery; D016031:Liver Transplantation / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging; D011859:Radiography; D012680:Sensitivity and Specificity; D015996:Survival Rate; D017131:Thrombectomy; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery