title: Portal vein arterialization using an accessory right hepatic artery in liver transplantation.
abstract: Portal vein thrombosis remains to be a challenging issue during liver transplantation even with the acquisition of innovative surgical techniques and years of experience. Most frequently, an initial eversion thromboendovenectomy is performed and depending on the extent of thrombosis and intraoperative findings, further revascularization options include venous jump grafts, portocaval hemitransposition, renoportal anastomosis or portal vein arterialization. Reports on these surgical approaches are limited although with acceptable outcomes. We present a 64-year-old patient with hepatitis C cirrhosis who underwent orthotopic liver transplantation with portal vein arterialization using an accessory right hepatic artery. Liver graft function has remained stable four years after transplant with notable aneurysmal dilatation of the portal vein.
authors.affiliation: Division of Transplantation, Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, USA. spaloyo@med.miami.edu
authors.forename: Siegfredo
authors.initials: S
authors.lastname: Paloyo
authors.forename: Seigo
authors.initials: S
authors.lastname: Nishida
authors.forename: Ji
authors.initials: J
authors.lastname: Fan
authors.forename: Akin
authors.initials: A
authors.lastname: Tekin
authors.forename: Gennaro
authors.initials: G
authors.lastname: Selvaggi
authors.forename: David
authors.initials: D
authors.lastname: Levi
authors.forename: Andreas
authors.initials: A
authors.lastname: Tzakis
mesh_terms: D000714:Anastomosis, Surgical; D006085:Graft Survival; D006499:Hepatic Artery / Q000601:surgery*; D006526:Hepatitis C / Q000628:therapy; D006801:Humans; D008099:Liver / Q000601:surgery; D008103:Liver Cirrhosis / Q000628:therapy; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000601:surgery*; D013927:Thrombosis / Q000601:surgery; D016896:Treatment Outcome