Interventional treatment of advanced portal vein occlusion after liver transplantation
10.3760/cma.j.cn113884-20230111-00012
- VernacularTitle:肝移植术后晚期门静脉闭塞介入治疗研究
- Author:
Encheng LIU
1
;
Guang CHEN
;
Haijun GAO
;
Hao WANG
;
Yilong JIAO
Author Information
1. 天津市第一中心医院放射介入科 天津市影像医学研究所，天津 300192
- Keywords:
Liver transplantation;
Advanced portal vein occlusion;
Interventional therapy
- From:
Chinese Journal of Hepatobiliary Surgery
2023;29(11):808-812
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy and safety of interventional treatment of advanced portal vein occlusion indifferent stages after liver transplantation.Methods:The clinical data of 13 patients with advanced portal vein occlusion after liver transplantation in Tianjin First Central Hospital from March 2016 to June 2022 were retrospectively analyzed, including 8 males and 5 females, with a median age of 47 (2 to 68) years. Based on the Yerdel’s Classification of portal vein thrombosis and Department of Radiology, Tianjin First Central Hospital practice experience, the classification of portal vein occlusion was further modified for a classification-base interventional treatment. The changes of portal vein pressure gradient, complications and protal vein after interventional treatment were analyzed.Results:All 13 cases underwent successful interventional treatment. A total of 15 stents were implanted in the 13 patients. The treatment time was (63.1±18.4) min. The pressure gradient at both ends of portal vein occlusion before treatment was [ M ( Q1, Q3)] 14.0 (9.5, 18.0) mmHg (1 mmHg=0.133 kPa), which declined after interventional treatment 1.0 (1.0, 2.5) mmHg ( Z=-3.19, P<0.001). Portal vein and right portal branch thrombosis recurred in one patient six days after interventional treatment, which was managed with re-interventional treatment. One patient underwent intrahepatic portal shunt through jugular vein 111 days after interventional treatment due to recurrent portal vein thrombosis. The other patients recovered uneventfully without recurrent portal vein thrombosis or occlusion during follow-ups. No intervention-related complications such as puncture point and intraperitoneal hemorrhage occurred in the patients. Conclusion:A modified classification-based interventional treatment could be safe and feasible for patients with advanced portal vein occlusion after liver transplantation.
