계명대학교 의학도서관 Repository

Liver Transplant for Patients With Preexisting Portal Vein Thrombosis: A Single-Center Experience

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Author(s)
Jeong Woo LeeTae-Seok KimKeun Soo AhnYong Hoon KimHyoung Tae KimKoo Jeong Kang
Keimyung Author(s)
Kim, Tae SeokAhn, Keun SooKim, Yong HoonKim, Hyoung TaeKang, Koo Jeong
Department
Dept. of Surgery (외과학)
Journal Title
Experimental and Clinical Transplantation
Issued Date
2019
Keyword
Jump graftRenoportal bypassSurgical complications
Abstract
Objectives:
Portal vein thrombosis is not uncommon in liver cirrhosis patients. Previously, portal vein throm - bosis had been considered as a contraindication to liver transplant because of technical challenges for adequate restoration of portal inflow followed by high morbidity and mortality. However, alternative options for portal vein thrombosis during liver transplant have been introduced, and portal vein thrombosis is now no longer considered as an absolute contraindication for liver transplant. Herein, we introduce our ex -periences and outcomes of liver transplant for patients with portal vein thrombosis.

Materials and Methods:
Between March 2014 and June 2018, 65 patients underwent liver transplant at our institution, with 13 (20%) having portal vein thrombosis preoperatively. The characteristics and management of these patients were reviewed retrospectively, and outcomes were compared with those of patients without portal vein thrombosis.

Results:
The type of portal vein thrombosis included Yerdel grade 1 in 7 patients (53.8%), grade 2 in 4 patients (30.8%), grade 3 in 1 patient (7.7%), and grade 4 in 1 patient (7.7%). For restoration of portal inflow, eversion thrombectomy was performed in 11 patients (84.6%), renoportal bypass in 1 patient (7.7%) with grade 4 portal vein thrombosis, and superior mesenteric vein jump graft in 1 patient (7.7%) with grade 2 portal vein thrombosis. There was no portal vein-related morbidity except for 1 patient who needed portal vein stent because of stricture. Outcomes after liver transplant were comparable among patients with and without portal vein thrombosis.

Conclusions:
Although the surgical procedure has a technical complexity, liver transplant is no longer a contraindication for patients with portal vein thrombosis because of various alternative options, allowing similar outcomes among patients with and without portal vein thrombosis.
Keimyung Author(s)(Kor)
김태석
안근수
김용훈
김형태
강구정
Publisher
School of Medicine (의과대학)
Citation
Jeong Woo Lee et al. (2019). Liver Transplant for Patients With Preexisting Portal Vein Thrombosis: A Single-Center Experience. Experimental and Clinical Transplantation. doi: 10.6002/ect.2019.0011
Type
Article
ISSN
2146-8427
Source
http://www.ectrx.org/detail/epub/1/1/1/0/827/0
DOI
10.6002/ect.2019.0011
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/42047
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Surgery (외과학)
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