Management of portal vein thrombosis during liver transplantation

Objectives To investigate the surgical options for the management of portal vein thrombosis(PVT) during liver transplantation and its impact on the outcome of patients.Methods Two hundred and forty-six cases of liver transplantation were analyzed retrospectively,along with literature review.Results PVT occurred in 31 patients,including 14 of grade I,8 of gradeⅡ,7 of grade Ⅲ,and 2 of grade IV.Simple thrombectomy or thrombus-extraction was performed in grade I and II PVT.Seven patients with grade Ⅲ PVT received a bypass procedure,using the donor iliac vein to act as a bridge between the donor portal vein and host superior mesenteric vein.Two cases of grade IV PVT received a modified cavo-portal hemitransposition.The postoperative 6-month mortality in the PVT and control groups was 6.5% and 7.4% respectively(P0.05).Conclusions PVT is not an absolute contraindication for liver transplantation.Good results can be obtained by applying reasonable operative procedures individually.