Cavoportal transposition for portal vein thrombosis in a pediatric living-related liver transplantation

Kumar, Nagappan; Atkison, Paul; Fortier, Marielle V.; Grant, David; Wall, William

doi:10.1053/jlts.2003.50150

Cited by 19 publications

(14 citation statements)

References 8 publications

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“…Immediate thrombectomy was performed but the patient had recurrent thrombosis and the graft was salvaged by a retrohepatic cavoportal anastomosis [6]. A non-anastomotic bile leak was observed in a solitary patient on 20th POD.…”

Section: Resultssupporting

confidence: 83%

Outcome of live donor liver transplantation in indian children with bodyweight <7.5 kg

et al. 2011

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This case-series analyzed the outcome of live donor liver transplantation (LT) performed in children <7.5 kg from January 2008 to June 2009 at our center. Five patients (3 males, 2 females, mean age, 8.2 ± .4 months; mean weight 6.8 ± 0.4 kg) underwent LT. The indications of LT included biliary atresia (3) and idiopathic neonatal hepatitis (2). Postoperative complications included acute rejection (1), portal venous thrombosis (1), bile leak (1), severe hypertension (1) and bacterial sepsis (4). There were no donor related complications. The median follow-up duration is 11 months with patient and graft survival rates of 100% each, respectively.

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Section: Resultssupporting

confidence: 83%

Outcome of live donor liver transplantation in indian children with bodyweight <7.5 kg

et al. 2011

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“…The graft was derived from living‐related liver donation. Eighteen months after LTx, the child was thriving on a normal diet without detection of ascites (35). Verran et al.…”

Section: Discussionmentioning

confidence: 99%

Surgical strategies for liver transplantation in the case of portal vein thrombosis – current role of cavoportal hemitransposition and renoportal anastomosis

Paškonis

Jurgaitis

Mehrabi

et al. 2006

Clinical Transplantation

113

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Portal vein thrombosis (PVT), a common complication of end stage liver disease, is no longer considered a definite contraindication for liver transplantation (LTx). The clinical decision to perform an LTx in the case of PVT depends on the degree of PVT and the experience of the surgeon. Eversion thromboendovenectomy was suggested by most authors as the surgical technique of choice for PVT grade 1, 2, and 3. If PVT obstructs more extended parts of the porto-mesenteric venous circulation, surgical options would include different types of venous jump graft reconstructions or arterialization of the portal vein. Combined liver and small bowel transplantation is another possible alternative. Cavoportal hemitransposition (CPHT) and renoportal anastomosis (RPA) were recently particularly advocated as creative surgical strategies in case of diffuse PVT. In this work, we focus on CPHT and RPA surgical techniques during LTx, which attempts to secure the portal flow to the liver graft in case of pre-existent diffuse PVT. We provide a review of all reported clinical experience at international clinical centers using these techniques. According to our meta-analysis a total of 15 studies were published on this topic between 1996 and 2005. In summary, a total of 56 orthotopic LTx have been performed in 53 patients (28 men, 25 women) combined with either CPHT or RPA, for the purpose of providing the donor graft with adequate inflow. Mean age was 44 yr including two patients who were infants, with the youngest recipient being two yr old. Main indications for LTx were liver cirrhosis caused by viral hepatitis, alcoholic cirrhosis and cryptogenic cirrhosis. CPHT was performed in 46 cases, and RPA in 10 cases. Thirty-five of 53 patients (66%) had surgery previous to LTx. Of these, 13 patients (37%) [corrected] presented with a history of other previous surgical procedures for decompression of portal hypertension or treatment of associated complications (portocaval shunts, splenectomy, etc). Ascites, renal dysfunction, lower extremity and torso edema and variceal bleeding were dominant post-operative complications after CPHT or RPA noted in 22 cases (41.5%), 18 cases (34%), 17 cases (32%) and 13 cases (24.5%) respectively. Patients' follow-up ranged from two to 48 months. Thirty nine of 53 patients [corrected] (74%) survived [corrected] and 14 patients died (26%) [corrected] during the course of observation. Based on the literature, we conclude that the ideal technique to overcome PVT during LTx is still controversial. Short-term follow-up results of both methods are promising, however, long-term results are unknown at present. Furthermore, clinical follow-up and basic experimental work is required to evaluate the influence of systemic venous inflow to the liver graft with respect to long-term liver function and liver regeneration.

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“…Portocaval hemitransposition has been adopted as a final resort or salvage procedure when no other technique is available. To date, 34 cases have been reported,1, 4, 5, 15, 16, 22–25 3 of them being pediatric patients5, 26, 27 (Table 2). In a review of 23 cases from 5 of the published papers,28 8 patients (35%) died from a variety of causes after transplantation, and 15 (65%) remain alive with longest follow‐up of 37 months.…”

Section: Discussionmentioning

confidence: 99%

Portocaval hemitransposition in pediatric liver transplant recipients: A single-center experience

et al. 2006

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Cavoportal transposition for portal vein thrombosis in a pediatric living-related liver transplantation

Abstract: We report a case of a living-related liver transplantation in a child in whom diffuse thrombosis of the portal venous system required the use of recipient vena cava to perfuse the donor portal vein (cavoportal transposition). An 8

Cited by 19 publications

References 8 publications

Outcome of live donor liver transplantation in indian children with bodyweight <7.5 kg

Outcome of live donor liver transplantation in indian children with bodyweight <7.5 kg

Surgical strategies for liver transplantation in the case of portal vein thrombosis – current role of cavoportal hemitransposition and renoportal anastomosis

Portocaval hemitransposition in pediatric liver transplant recipients: A single-center experience

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