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Langenbeck's Archives of Surgery

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01-12-2023 | Portal Vein Thrombosis | Brief report

Surgical strategies to treat portal vein thrombosis during adult liver transplantation

Authors: Martin de Santibanes, Victoria Ardiles, Jimmy Walker Uño, Juan Mattera, Eduardo de Santibanes, Juan Pekolj

Published in: Langenbeck's Archives of Surgery | Issue 1/2023

Abstract

Background

The incidence of portal vein thrombosis (PVT) at the time of liver transplantation (LT) may be variable and underestimated. Therefore, preoperative diagnosis and stratification of its extension is so relevant for adequate surgical planning. Revascularization of the portal vein graft becomes essential for graft and patient survival after LT. Early stages of PVT may be managed with eversion thrombectomy and end-to-end anastomoses. However, severe PVT (grades 3 and 4) poses significant challenges for patients requiring LT, resulting in more complex surgeries and higher complication rates. To address these complexities, various surgical techniques have been developed, including collateral alternative vessel utilization, renoportal anastomoses, mesoportal jump graft placement, cavoportal hemitranspositions, portal vein arterialization, or even multivisceral transplantation.

Purpose

We herein describe the preoperative surgical planning as well as the different surgical strategies possible to treat portal vein thrombosis during LT.

Conclusion

A comprehensive preoperative evaluation of PVT is crucial for accurately assessing its extent and severity. This information is vital for proper surgical planning, which ultimately prepares both the surgeon and the patient for potentially complex procedures during LT. The surgical alternatives presented in this technical report offer promising solutions for treating PVT during LT, making it a viable option for selected patients.

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Title: Surgical strategies to treat portal vein thrombosis during adult liver transplantation
Authors: Martin de Santibanes
Victoria Ardiles
Jimmy Walker Uño
Juan Mattera
Eduardo de Santibanes
Juan Pekolj
Publication date: 01-12-2023
Publisher: Springer Berlin Heidelberg
Keywords: Portal Vein Thrombosis
Portal Vein Thrombosis
Liver Transplantation
Liver Transplantation
Liver Transplantation
Liver Transplantation
Liver Transplantation
Thrombectomy
Published in: Langenbeck's Archives of Surgery / Issue 1/2023
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-023-03141-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Surgical strategies to treat portal vein thrombosis during adult liver transplantation

Abstract

Background

Purpose

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Purpose

Conclusion

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