Portal vein thrombosis: an emergency solution for blood flow in liver transplantation

Bernardos, Á.; Serrano, Juan Bautista Vivero; Gómez, Miguel Ángel; García, Ignacio Martín; Tamayo, María; Pareja, Felipe; Diaz, Concepción; Martín, Cristobalina

doi:10.1007/s00147-003-0575-5

Cited by 3 publications

(4 citation statements)

References 11 publications

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“…Renoportal anastomosis ensures adequate portal perfusion with a flow rate matching that of the native PV, and carries additional advantages such optimal coaxiality, congruence of the anastomosed vessels, and preservation of the retrohepatic inferior vena cava flow. Moreover, RPA obviates the specific and frequent complications associated with CPA . In addition, as Bhangui et al .…”

Section: Discussionmentioning

confidence: 99%

“…The most commonly observed complications after CPA have been ascites, renal dysfunction, variceal hemorrhage, and PV re‐thrombosis . Variceal bleeding has been reported in approximately 30% of patients, PV re‐thrombosis in 20–30% of patients, and chronic renal dysfunction in 40–50% of patients .…”

Section: Discussionmentioning

confidence: 99%

“…Caval inflow to the graft in the form of either a lateroterminal cavo‐portal anastomosis (CPA), or the termino‐terminal CPA, arterialization of the PV and combined liver‐small bowel transplantation/multi‐visceral transplantation (MVT) are techniques that have been proposed to overcome this obstacle. These approaches are associated with significant complications .…”

Section: Introductionmentioning

confidence: 99%

“…Cavoportal anastomosis has been associated with a number of postoperative complications, including lower torso edema and ascites in >50% of patients . In a large series of 23 CPAs described by Selvaggi et al .…”

Section: Introductionmentioning

confidence: 99%

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Renoportal anastomosis in liver transplantation and its impact on patient outcomes: a systematic literature review

et al. 2018

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Portal vein thrombosis (PVT) is commonly encountered during liver transplantation (LT). Depending on the grade of thrombosis, varied management strategies are indicated. The aims of this study are to clarify the contemporary role of renoportal anastomosis (RPA) in patients with splanchnic vein thrombosis (SVT) undergoing LT and to systematically analyze all reported cases of RPA. A systematic literature search was performed according to Preferred Reporting Items for Systematic Reviews and Meta‐ Analyses statement guidelines. The study was limited to studies reported in English between January 1997 and May 2017. Only retrospective single center studies were included in the analysis. A total of 66 patients with SVT were reported to have undergone RPA during LT. Transient renal dysfunction was reported in 12 patients (18.1%), variceal hemorrhage in 2 patients (3%), early portal vein (PV) re‐thrombosis in 2 patients (3%), chronic renal dysfunction in 2 patients (3%), and late PV re‐thrombosis in 1 patient (1.5%). The overall patient and graft survival were each 80%. This analysis illustrates the decades‐long evolution of a technique practiced across the field of transplantation. Postoperative complications and graft survival appear to be encouraging, even in the setting of SVT.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Renoportal anastomosis in liver transplantation and its impact on patient outcomes: a systematic literature review

et al. 2018

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Cavoportal Hemitransposition for Post Living Related Liver Transplant Portal Vein Thrombosis: A Valid Option

et al. 2008

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The Role of Cavoportal and Renoportal Hemitransposition in Liver Transplantation

et al. 2022

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Background Few series of cavoportal (CPA) or renoportal (RPA) anastomosis have been published and their survival rates have never been compared. The objective of this study was to evaluate perioperative and long-term outcomes of CPA and RPA in a nationwide multicentric series and to compare hemitranspositions (HT) to paired orthotopic liver transplantations (OLT). Material/Methods HT performed in France up to April 2019 were analyzed. Endpoints were the incidence of severe (Clavien-Dindo>IIIa) 90-day perioperative complications and long-term patient and graft survival. Results Sixty-four HT (13 CPA, 51 RPA) were performed in 59 patients. The rates of perioperative CD>IIIa complications were 64% and 49% in patients with CPA and RPA, respectively ( P =0.59), and the rates of portal thrombosis and ascites were 38.5% and 9.8% (p=0.023) and 53.8% and 21.6% (p=0.049) in patients with CPA and RPA, respectively. The patient and graft perioperative survival rates were 54.4% and 83.3% (HR=3.2; CI 95 [1.1–9.9]; p=0.039) and 54.4% and 77.1% (HR=2.2; CI 95 [0.77–6.4]; P =0.14) in the CPA and RPA groups, respectively. Five-year patient survival was 36.4% and 61.8% in the CPA and RPA groups, respectively (HR=2.5; CI 95 [1–6.1]; P =0.039). Compared with OLT grafts, long-term HT graft survival rates were not different (HR=1.7; CI 95 [0.96–3.1]; P =0.066), while patient survival rates were lower in the HT group (HR=4.6; CI 95 [2–11]; P <0.001). Conclusions Compared to OLT, HT significantly reduces patient survival. Given the poor survival results of CPA, the indication deserves to be limited in the context of organ shortage and RPA should be preferred when HT is needed.

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Portal vein thrombosis: an emergency solution for blood flow in liver transplantation

Abstract: Abstract

Cited by 3 publications

References 11 publications

Renoportal anastomosis in liver transplantation and its impact on patient outcomes: a systematic literature review

Renoportal anastomosis in liver transplantation and its impact on patient outcomes: a systematic literature review

Cavoportal Hemitransposition for Post Living Related Liver Transplant Portal Vein Thrombosis: A Valid Option

The Role of Cavoportal and Renoportal Hemitransposition in Liver Transplantation

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