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Modified Cavoportal Hemitransposition for Severe Portal Vein Thrombosis Contributed to Long-term Survival After Deceased Donor Liver Transplantation-Insight Into Portal Modulation for Improving Survival: A Case Report
- Source :
- Transplantation proceedings. 53(8)
- Publication Year :
- 2021
-
Abstract
- Background Severe/massive portal vein thrombosis (PVT) deteriorates peri-liver transplantation outcomes. Cavoportal hemitransposition (CPHT) is a rescue procedure for severe PVT, and short-term outcomes have been well studied. However, CPHT is associated with some long-term issues caused by portal flow modulation via extraordinary reconstruction. We describe a patient with Yerdel grade 4 PVT who underwent a liver transplant and achieved long-term survival with CPHT and a portosystemic shunt. Case Report A 50-year-old man with liver cirrhosis underwent a deceased donor liver transplant. Preoperative examinations indicated Yerdel grade 4 PVT; thus, we planned a CPHT. In liver transplant surgery, we confirmed diffusely complete PVT and removed them as possible. After placing a liver graft, we performed CPHT and confirmed that the graft received sufficient portal vein flow. However, the gastroepiploic vein pressure increased significantly. Therefore, we added a portosystemic shunt between the splenic vein and the inferior vena cava, and the pressure improved. The patient was discharged after an uneventful hospital stay, and he reported no unfavorable events for over 12 years. Conclusions This case study suggested that a modified CPHT with a portosystemic shunt for Grade 4 PVT was useful in preventing post–liver transplant PVT development and improved the outcome.
- Subjects :
- Liver Cirrhosis
Male
medicine.medical_specialty
Cirrhosis
medicine.medical_treatment
Liver transplantation
Inferior vena cava
Living Donors
Medicine
Humans
Vein
Venous Thrombosis
Transplantation
Deceased donor
business.industry
Portal Vein
Middle Aged
medicine.disease
Portal vein thrombosis
Surgery
Liver Transplantation
medicine.anatomical_structure
medicine.vein
Splenic vein
Portosystemic shunt
business
Subjects
Details
- ISSN :
- 18732623
- Volume :
- 53
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- Transplantation proceedings
- Accession number :
- edsair.doi.dedup.....ceda291e1e6bd312b5d722e3f71a469f