Skip to main content
PMC home page
Annals of Surgery logoLink to Annals of Surgery
. 1991 Mar;213(3):199–206. doi: 10.1097/00000658-199103000-00003

The spectrum of portal vein thrombosis in liver transplantation.

A C Stieber 1, G Zetti 1, S Todo 1, A G Tzakis 1, J J Fung 1, I Marino 1, A Casavilla 1, R R Selby 1, T E Starzl 1
PMCID: PMC1358327  PMID: 1998400

Abstract

Thrombosis of the portal vein with or without patency of its tributaries used to be a contraindication to orthotopic liver transplantation (OLTX) until quite recently. Rapid progress in the surgical technique of OLTX in the last few years has demonstrated that most patients with portal vein thrombosis can be safely and successfully transplanted. Presented here is a series of 34 patients with portal vein thrombosis transplanted at the University of Pittsburgh since 1984. The various techniques used to treat various forms of thrombosis are described. The survival rate for this series was 67.6% (23 of 34 patients). Survival was best for patients who underwent phlebothrombectomy or placement of a jump graft from the superior mesenteric vein. The survival rate also correlated with the amount of blood required for transfusion during surgery. Overall it is concluded that a vast majority of the patients with thrombosis of the portal system can be technically transplanted and that their survival rate is comparable to that of patients with patent portal vein.

Full text

PDF
204

Images in this article

200Fig. 1.
on p.200

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Asakawa H., Kasai S., Mito M. Flow- and pressure-adapted portal arterialization in dogs. Jpn J Surg. 1985 Jul;15(4):291–298. doi: 10.1007/BF02469920. [DOI] [PubMed] [Google Scholar]
  2. Cardella J. F., Castaneda-Zuniga W. R., Hunter D., Young A., Amplatz K. Angiographic and interventional radiologic considerations in liver transplantation. AJR Am J Roentgenol. 1986 Jan;146(1):143–153. doi: 10.2214/ajr.146.1.143. [DOI] [PubMed] [Google Scholar]
  3. HUNT A. H., WHITTARD B. R. Thrombosis of vein in cirrhosis hepatitis. Lancet. 1954 Feb 6;266(6806):281–284. doi: 10.1016/s0140-6736(54)91032-6. [DOI] [PubMed] [Google Scholar]
  4. Okuda K., Ohnishi K., Kimura K., Matsutani S., Sumida M., Goto N., Musha H., Takashi M., Suzuki N., Shinagawa T. Incidence of portal vein thrombosis in liver cirrhosis. An angiographic study in 708 patients. Gastroenterology. 1985 Aug;89(2):279–286. doi: 10.1016/0016-5085(85)90327-0. [DOI] [PubMed] [Google Scholar]
  5. Otte J. B., Reynaert M., De Hemptinne B., Geubel A., Carlier M., Jamart J., Lambotte L., Kestens P. J. Arterialization of the portal vein in conjunction with a therapeutic portacaval shunt. Hemodynamic investigations and results in 75 patients. Ann Surg. 1982 Dec;196(6):656–663. doi: 10.1097/00000658-198212001-00007. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Shaw B. W., Jr, Iwatsuki S., Bron K., Starzl T. E. Portal vein grafts in hepatic transplantation. Surg Gynecol Obstet. 1985 Jul;161(1):66–68. [PMC free article] [PubMed] [Google Scholar]
  7. Shaw B. W., Jr, Martin D. J., Marquez J. M., Kang Y. G., Bugbee A. C., Jr, Iwatsuki S., Griffith B. P., Hardesty R. L., Bahnson H. T., Starzl T. E. Venous bypass in clinical liver transplantation. Ann Surg. 1984 Oct;200(4):524–534. doi: 10.1097/00000658-198410000-00013. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Sheil A. G., Thompson J. F., Stephen M. S., Eyers A. A., Bookallil M., McCaughan G. W., Dorney S. F., Bell R., Mears D., Kelly G. E. Donor portal vein arterialization during liver transplantation. Transplant Proc. 1989 Feb;21(1 Pt 2):2343–2344. [PubMed] [Google Scholar]
  9. Tzakis A., Todo S., Starzl T. E. The anterior route for arterial graft conduits in liver transplantation. Transpl Int. 1989 Aug;2(2):121–121. doi: 10.1007/BF02459332. [DOI] [PubMed] [Google Scholar]
  10. Van Thiel D. H., Schade R. R., Starzl T. E., Iwatsuki S., Shaw B. W., Jr, Gavaler J. S., Dugas M. Liver transplantation in adults. Hepatology. 1982 Sep-Oct;2(5):637–640. doi: 10.1002/hep.1840020517. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Zajko A. B., Bron K. M., Starzl T. E., Van Thiel D. H., Gartner J. C., Iwatsuki S., Shaw B. W., Jr, Zitelli B. J., Malatack J. J., Urbach A. H. Angiography of liver transplantation patients. Radiology. 1985 Nov;157(2):305–311. doi: 10.1148/radiology.157.2.3901102. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES