Extra-anatomical Meso-portal Venous Jump Graft Repair for Early Portal Vein Thrombosis After Liver Transplant in an Infant With a Hypoplastic Portal Vein: A Case Report

R. Matsumoto, K. Uchida, Seigo Nishida, E. R. Island, D. M. Levi, Ji Fan, A. Tekin, G. Selvaggi, A. G. Tzakis

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Background and Purpose Small infants with biliary atresia and hypoplastic portal veins (PV) are at risk for portal vein thrombosis (PVT) after liver transplantation (LT), which can lead to graft loss and mortality. Extra-anatomical PV reconstruction techniques have been established for adult cases of PVT; however, they have not been widely accepted for infants. Methods Here, we report the successful use of an extra-anatomical meso-portal venous jump graft to treat early PVT after LT in a 6-month-old infant with biliary atresia and PV hypoplasia. At the time of LT, despite a reduced-sized left lateral graft, we had to create a temporary abdominal closure with silastic mesh. Findings On postoperative day 1, PVT was detected by Doppler ultrasound of the liver. Surgical thrombectomy was attempted. We removed the blood clots and reconstructed the PV using an interposition venous graft. As the PV flow was still not sufficient, we performed an extra-anatomical meso-portal venous jump graft procedure from the recipient superior mesenteric vein to the donor PV. This resulted in a significant improvement in PV flow. Conclusion For small infants at high risk for PVT, a detailed pretransplantation surgical plan and treatment options for possible early PVT are mandatory. An extra-anatomical meso-portal venous jump graft is a viable surgical technique for early PVT in infants.

Original languageEnglish (US)
Pages (from-to)3186-3190
Number of pages5
JournalTransplantation Proceedings
Volume48
Issue number9
DOIs
StatePublished - Nov 1 2016

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Fingerprint Dive into the research topics of 'Extra-anatomical Meso-portal Venous Jump Graft Repair for Early Portal Vein Thrombosis After Liver Transplant in an Infant With a Hypoplastic Portal Vein: A Case Report'. Together they form a unique fingerprint.

Cite this