TY - JOUR
T1 - A selective approach to preexisting portal vein thrombosis in patients undergoing liver transplantation
AU - Langnas, Alan N.
AU - Marujo, Wagner C.
AU - Stratta, Robert J.
AU - Wood, R. Patrick
AU - Ranjan, Dinesh
AU - Ozaki, Claire
AU - Shaw, Byers W.
PY - 1992/1
Y1 - 1992/1
N2 - 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.
AB - 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.
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U2 - 10.1016/0002-9610(92)90265-S
DO - 10.1016/0002-9610(92)90265-S
M3 - Article
C2 - 1733361
AN - SCOPUS:0026537377
VL - 163
SP - 132
EP - 136
JO - American Journal of Surgery
JF - American Journal of Surgery
SN - 0002-9610
IS - 1
ER -