Ten-year experience in porto-caval hemitransposition for liver transplantation in the presence of portal vein thrombosis

G. Selvaggi, D. Weppler, S. Nishida, J. Moon, D. Levi, T. Kato, A. G. Tzakis

Research output: Contribution to journalArticle

64 Scopus citations

Abstract

Porto-caval hemitransposition (PCH) in liver transplantation allows revascularization of the liver when the porto-mesenteric axis is thrombosed. We, here, review our experience over an 11-year period. A total of 23 patients underwent liver transplantation using PCH. Immunosuppression was based on tacrolimus, with sirolimus used in case of renal insufficiency. Most common diagnoses were hepatitis C, Laennec's, Budd-Chiari and cryptogenic cirrhosis. Six patients needed splenectomy prior to transplant, 5 during transplant, 1 post-transplant, 11 had no splenectomy. Overall survival was 60% at 1 year and 38% at 3 years, with 10 of 23 patients currently alive and the longest survivor at 9.3 years. Most common cause of death was sepsis/multisystem organ failure, followed by pulmonary embolism. A total of 7/23 patients experienced post-operative gastrointestinal bleeding episodes, 6/23 patients developed thrombosis of the vena cava (median 162 days post-op). Post-operative ascites was noted in almost all patients. Renal dysfunction was commonly seen even after the first month post-transplant. PCH offers a feasible option for liver transplantation in those patients with complex thrombosis of the mesenteric and portal circulation.

Original languageEnglish (US)
Pages (from-to)454-460
Number of pages7
JournalAmerican Journal of Transplantation
Volume7
Issue number2
DOIs
StatePublished - Feb 1 2007

    Fingerprint

Keywords

  • Liver transplantation
  • Portal vein thrombosis

ASJC Scopus subject areas

  • Immunology

Cite this