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Kakaei F, Nikeghbalian S, Salahi H, et al. Liver transplantation in the presence of old portal vein thrombosis. Int J Organ Transplant Med. 2010;1(1):44-8
Kakaei, F., Nikeghbalian, S., Salahi, H., Bahador, A., Kazemi, K., Dehghani, M., Shamsaeefar, A., Sanei, B., Ghaffaripour, S., Rajaei, E., Gholami, S., & Malek-Hosseini, S. A. (2010). Liver transplantation in the presence of old portal vein thrombosis. International journal of organ transplantation medicine, 1(1), 44-8.
Kakaei, F, et al. "Liver transplantation in the presence of old portal vein thrombosis." International journal of organ transplantation medicine vol. 1,1 (2010): 44-8.
Kakaei F, Nikeghbalian S, Salahi H, Bahador A, Kazemi K, Dehghani M, Shamsaeefar A, Sanei B, Ghaffaripour S, Rajaei E, Gholami S, Malek-Hosseini SA. Liver transplantation in the presence of old portal vein thrombosis. Int J Organ Transplant Med. 2010;1(1):44-8. Epub 2010 Feb 01. PMID: 25013563; PMCID: PMC4089218.
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Int J Organ Transplant Med. 2010;1(1):44-8. Epub 2010 Feb 01.

Liver transplantation in the presence of old portal vein thrombosis.

International journal of organ transplantation medicine

F Kakaei, S Nikeghbalian, H Salahi, A Bahador, K Kazemi, M Dehghani, A Shamsaeefar, B Sanei, S Ghaffaripour, E Rajaei, S Gholami, S A Malek-Hosseini

Affiliations

  1. Organ Transplant Research Center, Nemazi Hospital, Shiraz University of Medical Science, Shiraz, Iran.

PMID: 25013563 PMCID: PMC4089218

Abstract

BACKGROUND: Portal vein thrombosis (PVT) has been mentioned as a potential obstacle to liver transplantation (LTx).

OBJECTIVE: To review the impact of PVT on orthotopic liver transplant (OLT) outcome.

METHOD: Between January 2006 and April 2009, 440 OLT were performed in Shiraz Transplant Unit of whom, 35 (7.9%) cases had old PVT with recanalization. Data were retrospectively collected regarding the demographics, indication for OLT, Child-Turgot-Pugh classification, pre-transplant diagnosis of PVT, perioperative course and managements, relapse of PVT, early post-operative mortality and morbidity. All patients received liver from deceased donors, underwent thrombendvenectomy with end-to-end anastomosis without interposition graft and evaluated daily for 5 days and thereafter, biweekly by duplex sonography during the follow-up period for 2 months. They were treated by therapeutic doses of heparin followed by warfarin to maintain an INR of 2-2.5.

RESULTS: The causes of end-stage liver disease were hepatitis B in 11, cryptogenic cirrhosis in 11, primary sclerosing cholangitis in 5 and other causes in 8 recipients. Extension of thrombosis was through confluence of superior mesenteric and splenic vein in 32 and to superior mesenteric vein in 3 patients. The mean±SD operation time was 7.2±1.5 hrs. The mean±SD transfusion requirement was 5.4±2.8 units of packed cells. The mean±SD duration of hospital stay in these patients was 17.7±10.9 days. Eight patients died; 1 developed early in-hospital PVT, 1 had hepatic vein thrombosis, and 1 died of in-hospital ischemic cerebrovascular accident, despite a full anticoagulant therapy. The mean±SD follow-up period for those 28 patients discharged from hospital was 16.6±7.9 months; none of them developed relapse of PVT. The overall mortality and morbidity was 28% and 32%, respectively. There was no relapse of PVT in the other patients.

CONCLUSION: The presence of PVT at the time of OLT is not a contraindication for the operation but those with PVT have a more difficult surgery, develop more postoperative complications, and experience a higher in-hospital mortality.

Keywords: Iran; Portal vein thrombosis; liver transplantationl

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