Vascular complications after orthotopic liver transplantation

Новрузбеков, М. С.; Олисов, О. Д.

doi:10.23873/2074-0506-2017-9-1-35-50

Cited by 13 publications

(3 citation statements)

References 33 publications

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“…The study by Shaked and Busuttil also reported that the incidence of PVT was highest among patients with pre-existing pathologies of the portal vein, including chronic active hepatitis, hypercoagulable states, trauma or previous dissection of the porta hepatis, and splenectomy (37). Other factors include technical problems such as misalignment or excessive vessel length, ongoing rejection, liver fragment transplantation, using venous conduits in PVT, portosystemic shunts, and decreased portal flow from stenosis [ 5 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ]. In our institution, 2 of 20 (10%) patients who had undergone a splenectomy before LT developed PVT after LT. Of the remaining 340 patients without splenectomy before LT, only 5 (1.47%) developed post-LT PVT.…”

Section: Discussionmentioning

confidence: 99%

The Management of Portal Vein Thrombosis after Adult Liver Transplantation: A Case Series and Review of the Literature

Zhang

et al. 2022

JCM

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Background: Portal vein thrombosis (PVT) after adult liver transplantation (LT) is a rare but serious complication with no consensus on the ideal treatment. We report a case series and a comprehensive review of the literature on PVT after LT to discuss the therapeutic options. Methods: The clinical data of 360 adult patients (≥18 years of age) who underwent LT from January 2017 to January 2020 were reviewed, and a comprehensive search of PubMed and Web of Science was conducted. Patients diagnosed with PVT after LT were identified, and relevant risk factors and therapies were analyzed. Results: Among the 360 patients, 7 (1.94%) developed PVT after LT. Onset of PVT within one week after LT was found in six patients (85.71%). Four of the seven patients with PVT received systemic anticoagulation (low molecular weight heparin and warfarin) therapy. Minimally invasive interventional therapies combined with systemic anticoagulation (heparin and warfarin) were applied for three patients, two of whom died because of severe abdominal hemorrhage and liver failure. Of the 33 cases reported in the literature, minimally invasive interventional therapy combined with systematic anticoagulation or sclerotherapy were the most-used methods (20/33). Systemic anticoagulation was administered to four patients, and surgical operation (thrombectomy; portosystemic shunt and retransplantation) was performed for nine patients. Among these 33 patients, 4 eventually died. Conclusions: Interventional therapy combined with systemic anticoagulation is a good choice for the management of PVT after LT, and in our experience, systemic anticoagulation alone can also have a positive effect for early PVT patients.

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Section: Discussionmentioning

confidence: 99%

The Management of Portal Vein Thrombosis after Adult Liver Transplantation: A Case Series and Review of the Literature

Zhang

et al. 2022

JCM

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“…The study of Shaked and Busuttil also found that the incidence of PVT was highest among patients with pre-existing pathologies of the portal vein including chronic active hepatitis, hypercoagulable states, trauma or previous dissection of the porta hepatis, and splenectomy [32]. Other factors include technical problems such as misalignment or excessive vessel length, ongoing rejection, liver fragment transplantation, using venous conduits in PVT, portosystemic shunts and decreased portal ow from stenosis [4,[34][35][36][37][38][39][40]. In our institution, two of twenty (10%) patients who had undergone a splenectomy before LT developed PVT after LT. Of the remaining 240 patients without splenectomy before LT, only ve PVT can occur early or late after LT.…”

Section: Discussionmentioning

confidence: 99%

The Management of Portal Vein Thrombosis after Adult Liver Transplantation: A Case Series and Review of the Literature

Liu¹,

Wang²,

Ma³

et al. 2020

Preprint

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Background: Portal vein thrombosis (PVT) after adult liver transplantation (LT) is a rare but serious complication with no consensus on the ideal treatment. We report a case series and a comprehensive review of the literature on PVT after LT to discuss the therapeutic options. Methods: The clinical data of 360 adult patients (≥18 years of age) that underwent LT from January 2015 to January 2018 were reviewed, and a comprehensive search of PubMed and Web of Science was conducted. Patients diagnosed with PVT after LT were identified, and relevant risk factors and therapies were analyzed. Results: Among the 360 patients, seven (2.69%) developed PVT after LT. The onset of PVT within one week after LT was found in six patients (85.71%). Four of these seven patients with PVT received systemic anticoagulation (low molecular weight heparin and warfarin) therapy. Minimally invasive interventional therapies combined with systemic anticoagulation (heparin and warfarin) were applied to three patients, two of whom died because of severe abdominal hemorrhage and liver failure. In the 29 cases reported in the literature, minimally invasive interventional therapy combined with systematic anticoagulation or sclerotherapy were the most used methods (19/29). Systemic anticoagulation was administered to three patients, surgical operation (thrombectomy; portosystemic shunt and retransplantation) was performed for seven patients. Among these 29 patients, four eventually died. Conclusions: In conclusion, interventional therapy combined with systemic anticoagulation is a good choice for the management of PVT after LT, and in our experience, systemic anticoagulation alone can also have a positive effect for early PVT patients.

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“…Выбор любого из этих методов зависит от времени постановки диагноза [17]. Частота повторной трансплантации высока у пациентов без лечения тромбоза печеночной артерии (25-83%) по сравнению с пациентами, получившими реваскуляризацию трансплантата (28-35%) [9,18,19], и обеспечивает наилучшие результаты выживания. Однако эта возможность обусловлена нехваткой доноров и состоянием пациента [9,10,20,22].…”

Section: Introductionunclassified

Treatment of vascular complications following orthotopic liver transplantation. The experience of a regional cente

Korobka,

Kostrykin,

Malevanny

et al. 2023

RJTAO

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Objective: vascular complications (VCs) following liver transplantation (LT) can pose a significant threat to the recipient’s life – as the risk of graft loss increases significantly when blood flow in the graft is impaired. Diagnosis and early treatment of VCs seems to be a pressing issue in transplantology. The aim of this study is to evaluate the incidence, treatment and outcome of VCs in patients after orthotopic LT at the Center for Surgery and Donor Coordination, Rostov Regional Clinical Hospital.Materials and methods. Between July 2015 and April 2023, 100 orthotopic LTs were performed. VCs were retrospectively identified and analyzed.Results. The overall incidence of VCs was 24% (n = 24): hepatic artery stenosis, 5% (n = 5); intra-abdominal bleeding, 6% (n = 6); hepatic artery dissection, 2% (n = 2); intrahepatic venous thrombosis Budd–Chiari syndrome), 2% (n = 2); portal vein thrombosis, 1% (n = 1); inferior vena cava thrombosis/iliofemoral deep vein thrombosis, 2% (n = 2); inferior vena cava stenosis, 1% (n = 1); hepatic vein stenosis, 1% (n = 1); recurrent hepatic artery stenosis/thrombosis, 2% (n = 2); mesenteric vein thrombosis, 2% (n = 2).Conclusion. Most VCs following orthotopic LT occur in the early postoperative period and can lead to a high risk of graft dysfunction and patient death. Early recognition, diagnosis, and treatment of post-LT complications are critical to successful short- and long-term graft function and patient survival, even in patients with asymptomatic complications. Treatment options typically include surgical revascularization, percutaneous thrombolysis, percutaneous angioplasty, retransplantation, or, less commonly, a conservative approach.

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Vascular complications after orthotopic liver transplantation

Cited by 13 publications

References 33 publications

The Management of Portal Vein Thrombosis after Adult Liver Transplantation: A Case Series and Review of the Literature

The Management of Portal Vein Thrombosis after Adult Liver Transplantation: A Case Series and Review of the Literature

The Management of Portal Vein Thrombosis after Adult Liver Transplantation: A Case Series and Review of the Literature

Treatment of vascular complications following orthotopic liver transplantation. The experience of a regional cente

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