title: From portal to splanchnic venous thrombosis: What surgeons should bear in mind.
abstract: The present study aims to review the evolution of surgical management of portal (PVT) and splanchnic venous thrombosis (SVT) in the context of liver transplantation over the last 5 decades. PVT is more commonly managed by endovenous thrombectomy, while SVT requires more complex technical expedients. Several surgical techniques have been proposed, such as extensive eversion thrombectomy, anastomosis to collateral veins, reno-portal anastomosis, cavo-portal hemi-transposition, portal arterialization and combined liver-intestinal transplantation. In order to achieve satisfactory outcomes, careful planning of the surgical strategy is mandatory. The excellent results that are obtained nowadays confirm that, even extended, splanchnic thrombosis is no longer an absolute contraindication for liver transplantation. Patients with advanced portal thrombosis may preferentially be referred to specialized centres, in which complex vascular approaches and even multivisceral transplantation are performed.
authors.affiliation: Quirino Lai, Jan Lerut, Starzl Unit of Abdominal Transplantation, University Hospitals Saint-Luc, Université Catholique Louvain, B-1200 Brussels, Belgium.
authors.forename: Quirino
authors.initials: Q
authors.lastname: Lai
authors.affiliation: Quirino Lai, Jan Lerut, Starzl Unit of Abdominal Transplantation, University Hospitals Saint-Luc, Université Catholique Louvain, B-1200 Brussels, Belgium.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Spoletini
authors.affiliation: Quirino Lai, Jan Lerut, Starzl Unit of Abdominal Transplantation, University Hospitals Saint-Luc, Université Catholique Louvain, B-1200 Brussels, Belgium.
authors.forename: Rafael S
authors.initials: RS
authors.lastname: Pinheiro
authors.affiliation: Quirino Lai, Jan Lerut, Starzl Unit of Abdominal Transplantation, University Hospitals Saint-Luc, Université Catholique Louvain, B-1200 Brussels, Belgium.
authors.forename: Fabio
authors.initials: F
authors.lastname: Melandro
authors.affiliation: Quirino Lai, Jan Lerut, Starzl Unit of Abdominal Transplantation, University Hospitals Saint-Luc, Université Catholique Louvain, B-1200 Brussels, Belgium.
authors.forename: Nicola
authors.initials: N
authors.lastname: Guglielmo
authors.affiliation: Quirino Lai, Jan Lerut, Starzl Unit of Abdominal Transplantation, University Hospitals Saint-Luc, Université Catholique Louvain, B-1200 Brussels, Belgium.
authors.forename: Jan
authors.initials: J
authors.lastname: Lerut
keywords: Cavo-portal hemi-transposition; Intestinal transplantation; Liver transplantation; Multi-visceral transplant; Portal vein arterialization; Portal vein thrombosis; Splanchnic vein thrombosis; Spleno-renal shunt; Thrombectomy; Vascular graft