title: Gastric coronary vein to portal vein reconstruction in liver transplant: case report.
abstract: OBJECTIVE
  Portal vein thrombosis is a common complication in end-stage liver diseases of candidates for liver transplant. Most portal vein thromboses can be removed with thrombectomy. However, if the thrombosis extends to the distal superior mesenteric vein, it is difficult to reconstruct the portal vein. We report herein a case of dilated gastric coronary vein to portal vein reconstruction in liver transplant.
  
  
  METHODS
  During the operation, the portal vein thrombosis was confirmed; it extended to the distal superior mesenteric vein. It could not be removed, and a jumping graft vein could not be used either. The dilated gastric coronary vein was dissected. After a piggy-back caval anastomosis, the recipient gastric coronary vein was anastomosed to donor portal vein using side-to-end anastomosis. Successive ultrasound studies demonstrated patent portal anastomosis. At postoperative day 30, computed tomography scans confirmed the patency of the portal anastomosis. The patient recovered fully and at the time of this writing, was doing well 1 year after transplant. Neither ascites nor upper gastrointestinal bleeding occurred.
  
  
  CONCLUSIONS
  If complete portal vein thrombosis extends to the distal superior mesenteric vein, and a jumping graft vein cannot be applied, the recipient gastric coronary vein or other collateral varix anastomosed to the donor portal vein is an alternative.
authors.affiliation: From the Department of Transplant, California Pacific Medical Center, 2340 Clay Street, Suite 118, San Francisco, California 94115, USA and the Department of General Surgery, First Affiliated Hospital, Xinxiang Medical University, 100 Jiankang Road, Weihui, Henan 453003, China.
authors.forename: Zifa
authors.initials: Z
authors.lastname: Wang
authors.forename: Libin
authors.initials: L
authors.lastname: Yang
mesh_terms: D000714:Anastomosis, Surgical; D004108:Dilatation, Pathologic; D058625:End Stage Liver Disease / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008642:Mesenteric Veins / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D010690:Phlebography / Q000379:methods; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D019651:Plastic Surgery Procedures; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D014654:Vascular Patency; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*