Liver Transplantation in Patients with Portal Vein Thrombosis: a single center experience

Adequate portal inflow is a key element to obtain a successful liver transplantation, unfortunately patients may present with portal vein thrombosis at the moment of surgery. Surgical techniques have evolved during the years, allowing these patients to undergo successful liver transplantation, with a survival rate comparable to patients without portal vein thrombosis. Between January 2000 and December 2015, at Hospital Papa Giovanni XXIII in Bergamo (Italy), 763 adult patients underwent liver transplantation, 69 of which presented with portal vein thrombosis. We retrospectively analyzed pre-,intra-,and postoperative data, including outcomes. Four types of surgical solutions were used, according to patients’ conditions and Yerdel’s classification: venous thrombectomy, consisting in the simple removal of the obstructing thrombus, use of portal vein collaterals, use of renal vein, and use of jump graft technique. Of the 69 patients analyzed, 57 were treated just with thromboectomy, 5 by anastomosing the donor portal vein on a collateral of the recipient, 4 by creating a reno-portal anastomosis, and 3 by using the jump graft technique. 50 patients survived up to now and 19 patients died, 7 within perioperative period. The overall survival at 5 years of the transplanted cohort is 77.5%, and of the PVT population is 71.8%, showing no significant statistical difference between them.