Liver Transplantation in Patients With Complete Portal Vein Thrombosis: Renoportal or Varicoportal Anastomosis Using Cryopreserved Vein Grafts
| Autor: | Hikmet Aktas, Remzi Emiroglu, Ali Ozer, Osman Serhat Guner, Ercument Gurluler |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Vein graft Iliac Vein 030230 surgery Liver transplantation Anastomosis Renal Veins Cryopreservation 03 medical and health sciences 0302 clinical medicine Living Donors Humans Medicine In patient Venous Thrombosis Transplantation Portal Vein business.industry Liver Diseases Anastomosis Surgical Middle Aged medicine.disease Liver Transplantation Surgery Portal vein thrombosis Survival Rate Hepatocellular carcinoma Vascular Grafting 030211 gastroenterology & hepatology Radiology business Cadaveric spasm |
| Zdroj: | Transplantation Proceedings. 49:1820-1823 |
| ISSN: | 0041-1345 |
| DOI: | 10.1016/j.transproceed.2017.06.029 |
| Popis: | Background Despite technical developments in transplantation surgery, complete portal vein thrombosis still remains a challenge for restoration of adequate portal vein inflow. Renoportal or varicoportal anastomosis provides an effective alternative solution for patients with complete portal vein thrombosis. This study describes our experience with renoportal and varicoportal anastomosis during liver transplantation. Patients and methods Between January 2014 and May 2016, 5 patients with complete portal vein thrombosis underwent extra-anatomic portal anastomosis. In 3 cases, varicoportal anastomosis was performed and for the others, end-to-end renoportal anastomosis. We used iliac cryopreserved vein grafts to restore portal anastomosis in 3 cases. Epidemiology, risk factors, surgical techniques, complications, and outcomes of these procedures were evaluated over short- and long-term follow-ups. Results The follow-up time is 3 years for our first renoportal case, which was performed in a cadaveric liver transplantation; it was also first nationwide case. The other renoportal anastomosis was practiced in a living donor liver transplantation and the follow-up time is 8 months. The patient and graft survival rates were 100% at the last follow-up. The follow-up times are 10.9 and 4 months for the patients with varicoportal anastomosis. One of these patients died due to recurrence of hepatocellular carcinoma. The other two patients are alive with good graft functions. Conclusion Our experience suggests that reno-varicoportal anastomosis is a useful technique for patients with complete portal vein thrombosis and cryopreserved grafts may be safely used. |
| Databáze: | OpenAIRE |
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