title: Single-center experience of living donor liver transplantation in patients with portal vein thrombosis.
abstract: Portal vein thrombosis (PVT) is a relative contraindication in living donor liver transplantation (LDLT). We investigated the long-term outcome of adult patients with PVT in LDLT.
  
  
  
  Between 2004 and 2009, 471 cases of adult LDLT were performed and 56 patients had PVT (11.8%). Thrombectomy was attempted using a modified eversion technique. We evaluated the outcome of patients with PVT according to grade and compared with no-PVT patients.
  
  
  
  There was no difference in terms of age, gender, Child-Pugh score, MELD score, proportion of malignance, operation time, and total amount of transfused blood. Complete thrombectomy was successful in 73.2% (41/56), partial thrombectomy in 26.8% (15/56), and one case needed jump graft for portal vein reconstruction. Among patients with partial thrombectomy, when the PV velocity was above 20 cm/s, the remnant thrombus disappeared in 46%. The rate of PV complication was statistically not different (8.9% vs 3.4%, P=.062). Five-year survival of mild PVT was 69.3%, 60.6% for severe PVT, and 80.4% for no-PVT (P=.059).
  
  
  
  Eversion thrombectomy by modified technique is feasible in most cases of PVT. Good long-term outcome may be expected in LDLT with PVT.
authors.affiliation: Department of Surgery, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea.
authors.forename: Sanghyun
authors.initials: S
authors.lastname: Song
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. chdkwon@skku.edu.
authors.forename: Choon Hyuck David
authors.initials: CH
authors.lastname: Kwon
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Jong Man
authors.initials: JM
authors.lastname: Kim
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Jae-Won
authors.initials: JW
authors.lastname: Joh
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Suk-Koo
authors.initials: SK
authors.lastname: Lee
mesh_terms: D064591:Allografts; D058625:End Stage Liver Disease / Q000150:complications* / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D017131:Thrombectomy / Q000379:methods*; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery
keywords: liver transplantation; living donor; portal vein thrombosis; survival; thrombectomy