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Arch Surg. 1996 Aug;131(8):840-4; discussion 844-5.

Improved results of liver transplantation in patients with portal vein thrombosis.

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1
Dumont-UCLA Liver Transplant Program, UCLA School of Medicine, USA.

Abstract

OBJECTIVE:

To analyze the impact of preexisting portal vein thrombosis (PVT) on the operative management and outcome of liver transplantation.

DESIGN:

Retrospective review of 1423 patients who received transplants over 11 years.

SETTING:

Tertiary referral center.

PATIENTS OR OTHER PARTICIPANTS:

Seventy patients who underwent liver transplantation who had preexisting PVT.

INTERVENTIONS:

Portal vein thromboendovenectomy, vein grafting, or use of portal collateral veins for inflow during liver transplantation.

MAIN OUTCOME MEASURES:

Postoperative PVT, intraoperative transfusion, retransplantation rate, 30-day and 1-year actuarial survival rates.

RESULTS:

Operative management consisted of thromboendovenectomy in 61 cases, vein graft to the superior mesenteric vein in 6 cases, and vein graft to other mesenteric veins in 3 cases. The incidence of posttransplant PVT was 3% (n = 2). The mean +/- SD transfusion requirement was 23 +/- 18 U. The 1-year actuarial survival rate was 74% but improved from 66% in the first 35 cases to 82% in the latter 35 cases.

CONCLUSIONS:

Thromboendovenectomy is the procedure of choice for PVT. Results of liver transplantation in patients with PVT improve significantly with experience gained and are equivalent to results in patients without PVT.

[Indexed for MEDLINE]

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