Clinical analysis of 18 patients with portal vein stenosis after liver transplantation
10.3969/j.issn.1674-7445.2017.06.007
- VernacularTitle:肝移植术后门静脉狭窄18例临床分析
- Author:
Mei ZHANG
1
,
2
;
Xiaogang ZHANG
;
Min TIAN
;
Jianhua SHI
;
Rongfeng WANG
;
Xuemin LIU
;
Bo WANG
;
Yi LYU
Author Information
1. 710061 西安交通大学医学部
2. 西安交通大学第一附属医院肝胆外科
- Keywords:
Liver transplantation;
Portal vein stenosis;
Vascular complication;
Liver cirrhosis;
Portal vein thrombosis;
CT angiography;
Balloon angioplasty;
Stent implantation;
Anticoagulant treatment
- From:
Organ Transplantation
2017;8(6):445-449
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the experience of clinical diagnosis and treatment of portal vein stenosis after liver transplantation. Methods Clinical data of 18 patients presenting with portal vein stenosis after undergoing liver transplantation were retrospectively analyzed. The incidence, treatment and prognosis of portal vein stenosis were summarized. Results Seventeen patients had a medical history of liver cirrhosis before liver transplantation, 7 cases with a medical history of portal vein thrombosis and 8 cases with a medical history of devascularization or shunt with splenectomy. Three cases received the pediatric liver grafts. Eighteen patients suffered from portal vein stenosis from postoperative 23 d to 24 months with a median time of 2.2 months, which was detected by color Doppler ultrasound (CDU) and diagnosed by CT angiography (CTA) of the portal vein or interventional therapy. After the diagnosis was confirmed,all cases received anticoagulant treatment by warfarin. Five patients with portal hypertension underwent balloon dilatation,and one of them received endovascular stent implantation simultaneously. The remaining 13 patients received conservative therapy. After corresponding treatment, 9 cases were mitigated, 7 patients remained unchanged and 2 cases were aggravated. Conclusions For the recipients with a medical history of liver cirrhosis before liver transplantation, portal vein stenosis should be monitored by conventional CDU and diagnosed by CTA or interventional therapy after transplantation. Patients without clinical symptoms can receive conservative treatment. Those complicated with portal hypertension can undergo interventional therapy. Favorable clinical prognosis is obtained in most cases.
