A selective approach to preexisting portal vein thrombosis in patients undergoing liver transplantation

Alan N. Langnas, Wagner C. Marujo, Robert J. Stratta, R. Patrick Wood, Dinesh Ranjan, Claire Ozaki, Byers W. Shaw

Research output: Contribution to journalArticlepeer-review

58 Scopus citations

Abstract

Splanchnic venous inflow is considered mandatory to ensure graft survival after liver transplantation. Over a 68-month period, we performed 570 liver transplants in 495 patients. Portal vein thrombosis was present in 16 patients. At transplant, the extent of the occlusion included portal vein alone (n = 4), portal including confluence of the splenic and superior mesenteric veins (n = 8), portal, splenic, and distal superior mesenteric veins (n = 2), and the entire portal vein, splenic vein, and superior mesenteric vein (n = 2). The operative approach included thrombectomy alone (n = 5), anastomosis at the confluence of the splenic and superior mesenteric splenic veins (n = 8), and extra-anatomic venous reconstruction (n = 3). The mean operative blood loss was 22 ± 22 units, and the mean operative time was 9.7 ± 4.8 hours. The 1-year actuarial survival rate was 81%, with a mean follow-up of 12.5 months. In summary, with a selective approach and the use of innovative forms of splanchnic venous inflow, portal vein thrombosis is no longer a contraindication to liver transplantation.

Original languageEnglish (US)
Pages (from-to)132-136
Number of pages5
JournalThe American Journal of Surgery
Volume163
Issue number1
DOIs
StatePublished - Jan 1992

ASJC Scopus subject areas

  • Surgery

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