A selective approach to preexisting portal vein thrombosis in patients undergoing liver transplantation

Am J Surg. 1992 Jan;163(1):132-6. doi: 10.1016/0002-9610(92)90265-s.


Splanchnic venous inflow is considered mandatory to ensure graft survival after liver transplantation. Over a 68-month period, we performed 570 liver transplants in 495 patients. Portal vein thrombosis was present in 16 patients. At transplant, the extent of the occlusion included portal vein alone (n = 4), portal including confluence of the splenic and superior mesenteric veins (n = 8), portal, splenic, and distal superior mesenteric veins (n = 2), and the entire portal vein, splenic vein, and superior mesenteric vein (n = 2). The operative approach included thrombectomy alone (n = 5), anastomosis at the confluence of the splenic and superior mesenteric splenic veins (n = 8), and extra-anatomic venous reconstruction (n = 3). The mean operative blood loss was 22 +/- 22 units, and the mean operative time was 9.7 +/- 4.8 hours. The 1-year actuarial survival rate was 81%, with a mean follow-up of 12.5 months. In summary, with a selective approach and the use of innovative forms of splanchnic venous inflow, portal vein thrombosis is no longer a contraindication to liver transplantation.

MeSH terms

  • Actuarial Analysis
  • Child, Preschool
  • Contraindications
  • Follow-Up Studies
  • Graft Survival
  • Humans
  • Liver Transplantation* / physiology
  • Middle Aged
  • Portal Vein*
  • Thrombosis / surgery*