Percutaneous Interventional Treatment for Portal Vein Thrombosis Combined with Occlusion Following Liver Transplantation_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZHANGSheng-ning ¹ , ZHONGYue-ming ² , ZHAOYong-heng ¹ , CHENYong-lin ¹ , CHENWen-zhong ² , LILai-bang ¹ , LIUJing ¹ , RANJiang-hua ¹ , LILi ¹

1. The First Department of Hepatopancreatobiliary Surgery, Affiliated Calmette Hospital of Kunming Medical University and The First People's Hospital of Kunming City, Liver Transplantation Center of Organ Transplantation Institute of Yunnan Province, Kunming 650011, Yunnan Province, China;
2. Department of Interventional Radiology, The First People's Hospital of Kunming City, Kunming 650011, Yunnan Province, China;

Corresponding author：

ZHANGSheng-ning, Email: zsn813@163.com

Keywords：

Liver transplantation; Portal vein thrombosis; Complications; Intervetional treatment

DOI：

10.7507/1007-9424.20150378

Video：

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Objective To evaluate value of percutaneous interventional treatment for portal vein thrombosis combined with occlusion following liver transplantation. Method The data of 3 patients with portal vein thrombosis combined with occlusion following liver transplantation underwent interventional treatment were analyzed retrospectively. Results the mural thrombi were detected preoperatively in the portal venous trunk for the 3 patients, all of which were classified as Yerdel's grade 1 and were underwent porto-portal anastomosis without thrombectomy during liver transplantation. Portal vein thrombosis combined with occlusion occured after 8 months postoperatively. The percutaneous transhepatic balloon venoplasty and self-expanding metallic stents placement was performed in 3 patients. The interventional treatment was successfully achieved in all the patients. The follow-up period ranged from 28 to 38 months, no complications occurred following interventional treatment, the graft function and survival of patients were good. Conclusion Percutaneous interventional treatment is an efficacious and safe method to treat portal vein thrombosis combined with occlusion.

Citation： ZHANGSheng-ning, ZHONGYue-ming, ZHAOYong-heng, CHENYong-lin, CHENWen-zhong, LILai-bang, LIUJing, RANJiang-hua, LILi. Percutaneous Interventional Treatment for Portal Vein Thrombosis Combined with Occlusion Following Liver Transplantation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(12): 1439-1442. doi: 10.7507/1007-9424.20150378 Copy

1.	Yerdel MA, Gunson B, Mirza D, et al. Portal vein thrombosis in adults undergoing liver transplantation: risk factors, screening, management, and outcome. Transplantation, 2000, 69(9): 1873-1881.
2.	Ponziani FR, Zocco MA, Senzolo M, et al. Portal vein thrombosis and liver transplantation: implications for waiting list period, surgical approach, early and late follow-up. Transplant Re(Orlando), 2014, 28(2): 92-101.
3.	Khalaf H. Vascular complications after deceased and living donor liver transplantation: a single-center experience. Transplant Proc, 2010, 42(3): 865-870.
4.	Ueda M, Oike F, Kasahara M, et al. Portal vein complications in pediatric living donor liver transplantation using left-side grafts. Am J Transplant, 2008, 8(10): 2097-2105.
5.	Jia YP, Lu Q, Gong S, et al. Postoperative complications in patients with portal vein thrombosis after liver transplantation: evaluation with Doppler ultrasonography. World J Gastroenterol, 2007, 13(34): 4636-4640.
6.	Sharma R, Kashyap R, Jain A, et al. Surgical complications following liver transplantation in patients with portal vein thrombosis-a single-center perspective. J Gastrointest Surg, 2010, 14(3): 520-527.
7.	Feltracco P, Barbieri S, Cillo U, et al. Perioperative thrombotic complications in liver transplantation. World J Gastroenterol, 2015, 21(26): 8004-8013.
8.	Hejazi Kenari SK, Zimmerman A, Eslami M, et al. Current state of art management for vascular complications after liver transplantation.Middle East J Dig Dis, 2014, 6(3): 121-130.
9.	Harding DJ, Perera MT, Chen F, et al. Portal vein thrombosis in cirrhosis: Controversies and latest developments. World J Gastroen-terol, 2015, 21(22): 6769-6784.
10.	Cherukuri R, Haskal ZJ, Naji A, et al. Percutaneous thrombolysis and stent placement for the treatment of portal vein thrombosis after liver transplantation: long-term follow-up. Transplantation, 1998, 65(8): 1124-1126.
11.	Kensinger CD, Sexton KW, Baron CM, et al. Management of portal vein thrombosis after liver transplantation with a combined open and endovascular approach. Liver Transpl, 2015, 21(1): 132-134.
12.	Baccarani U, Gasparini D, Risaliti A, et al. Percutaneous mechanical fragmentation and stent placement for the treatment of early posttransplantation portal vein thrombosis. Transplantation, 2001, 72(9): 1572-1582.
13.	Saad WE, Madoff DC. Percutaneous portal vein access and transhe-patic tract hemostasis. Semin Intervent Radiol, 2012, 29(2): 71-80.
14.	Villiger P, Ryan EA, Owen R, et al. Prevention of bleeding after islet transplantation: lessons learned from a multivariate analysis of 132 cases at a single institution. Am J Transplant, 2005, 5(12): 2992-2998.
15.	张荣生, 王轩, 张斌, 等.肝移植术后门静脉血栓形成的介入治疗(附1例报道).中国普外基础与临床杂志, 2010, 17(5): 442.
16.	Saad WE. Portal interventions in liver transplant recipients. Semin Intervent Radiol, 2012, 29(2): 99-104.
17.	Ueda M, Egawa H, Ogawa K, et al. Portal vein complications in the long-term course after pediatric living donor liver transplantation. Transplant Proc, 2005, 37(2): 1138-1140.
18.	Durham JD, Laberge JM, Altman S, et al. Portal vein thrombolysis and closure of competitive shunts following liver transplantation. J Vasc Interv Radiol, 1994, 5(4): 611-618.
19.	Glynn RJ, Ridker PM, Goldhaber SZ, et al. Effect of low-dose aspirin on the occurrence of venous thromboembolism: a randomized trial. Ann Intern Med, 2007, 147(8): 525-533.

1. Yerdel MA, Gunson B, Mirza D, et al. Portal vein thrombosis in adults undergoing liver transplantation: risk factors, screening, management, and outcome. Transplantation, 2000, 69(9): 1873-1881.
2. Ponziani FR, Zocco MA, Senzolo M, et al. Portal vein thrombosis and liver transplantation: implications for waiting list period, surgical approach, early and late follow-up. Transplant Re(Orlando), 2014, 28(2): 92-101.
3. Khalaf H. Vascular complications after deceased and living donor liver transplantation: a single-center experience. Transplant Proc, 2010, 42(3): 865-870.
4. Ueda M, Oike F, Kasahara M, et al. Portal vein complications in pediatric living donor liver transplantation using left-side grafts. Am J Transplant, 2008, 8(10): 2097-2105.
5. Jia YP, Lu Q, Gong S, et al. Postoperative complications in patients with portal vein thrombosis after liver transplantation: evaluation with Doppler ultrasonography. World J Gastroenterol, 2007, 13(34): 4636-4640.
6. Sharma R, Kashyap R, Jain A, et al. Surgical complications following liver transplantation in patients with portal vein thrombosis-a single-center perspective. J Gastrointest Surg, 2010, 14(3): 520-527.
7. Feltracco P, Barbieri S, Cillo U, et al. Perioperative thrombotic complications in liver transplantation. World J Gastroenterol, 2015, 21(26): 8004-8013.
8. Hejazi Kenari SK, Zimmerman A, Eslami M, et al. Current state of art management for vascular complications after liver transplantation.Middle East J Dig Dis, 2014, 6(3): 121-130.
9. Harding DJ, Perera MT, Chen F, et al. Portal vein thrombosis in cirrhosis: Controversies and latest developments. World J Gastroen-terol, 2015, 21(22): 6769-6784.
10. Cherukuri R, Haskal ZJ, Naji A, et al. Percutaneous thrombolysis and stent placement for the treatment of portal vein thrombosis after liver transplantation: long-term follow-up. Transplantation, 1998, 65(8): 1124-1126.
11. Kensinger CD, Sexton KW, Baron CM, et al. Management of portal vein thrombosis after liver transplantation with a combined open and endovascular approach. Liver Transpl, 2015, 21(1): 132-134.
12. Baccarani U, Gasparini D, Risaliti A, et al. Percutaneous mechanical fragmentation and stent placement for the treatment of early posttransplantation portal vein thrombosis. Transplantation, 2001, 72(9): 1572-1582.
13. Saad WE, Madoff DC. Percutaneous portal vein access and transhe-patic tract hemostasis. Semin Intervent Radiol, 2012, 29(2): 71-80.
14. Villiger P, Ryan EA, Owen R, et al. Prevention of bleeding after islet transplantation: lessons learned from a multivariate analysis of 132 cases at a single institution. Am J Transplant, 2005, 5(12): 2992-2998.
15. 张荣生, 王轩, 张斌, 等.肝移植术后门静脉血栓形成的介入治疗(附1例报道).中国普外基础与临床杂志, 2010, 17(5): 442.
16. Saad WE. Portal interventions in liver transplant recipients. Semin Intervent Radiol, 2012, 29(2): 99-104.
17. Ueda M, Egawa H, Ogawa K, et al. Portal vein complications in the long-term course after pediatric living donor liver transplantation. Transplant Proc, 2005, 37(2): 1138-1140.
18. Durham JD, Laberge JM, Altman S, et al. Portal vein thrombolysis and closure of competitive shunts following liver transplantation. J Vasc Interv Radiol, 1994, 5(4): 611-618.
19. Glynn RJ, Ridker PM, Goldhaber SZ, et al. Effect of low-dose aspirin on the occurrence of venous thromboembolism: a randomized trial. Ann Intern Med, 2007, 147(8): 525-533.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Percutaneous Interventional Treatment for Portal Vein Thrombosis Combined with Occlusion Following Liver Transplantation

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