Liver transplantation in end stage liver disease with portal vein thrombosis (report of 4 cases)
- VernacularTitle:终末期肝病合并门静脉血栓患者的肝移植术(附四例报告)
- Author:
Qiyuan LIN
;
Jiayin YANG
;
Lunan YAN
- Publication Type:Journal Article
- Keywords:
Venous Thrombosis;
Liver transplantation;
Complication
- From:
Chinese Journal of Organ Transplantation
2003;0(06):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the liver transplantation in end stage liver disease with portal vein thrombosis (PVT). Methods Computer Tomography and color Doppler examinations were performed on the recipients to be subject to liver transplantation. Four male cases were found having PVT, received orthotopic liver transplantation and thrombectomy. Cell Saver auto transfusion blood and venous by-pass was also conventionally used. By reason of one case with residual thrombosis, a catheter with heparin cap was inserted into the branch of superior mesentery vein, followed by perfusion of urokinase for thrombus dissolution. Anti-coagulation treatments with low molecule heparin and Prostaglandtin E1 after operation were carried on in all of the patients. Results Surgical management of PVT were successful only one time in 3 patients. One patient with PVT extending over the entrance of spleen vein and left and right portal vein branches had portal vein residual thrombosis postoperation. After dissolution and anti-coagulation for 28 days, the residual thrombus disappeared. One cured patient with PVT died 48 days after operation from lung infection due to multiocular effusion resulting from chest cavity bleeding after pleuracentesis, and other 3 patients were cured in 2 months. Conclusion The PVT is not an absolute contraindication to liver transplantation; Thrombectomy combined with thrombus dissolution and anticoagulation can cure PVT; Prevention of bleedings in the patients with PVT is very importance postoperation.
