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Volume: 6 Issue: 4 November 2008 - Supplement - 1



Portal vein thrombosis (PVT) has been mentioned as a potential obstacle to liver transplantation (LTx). The present study was conducted in an effort to review the impact of PVT on LTx outcome. Between June 2006 and July 2008, 253 OLT were performed in Shiraz transplant unit including 25 cases (9.9%) showing PVT. Data were retrospectively collected regarding the demographics, indication for liver transplantation, Child-Turgot-Pugh classification, pretransplant diagnosis of PVT, perioperative course and managements, relapse of PVT, early postoperative mortality and morbidity. All patients received livers from deceased donors, were undergone thromboendvenectomy with end-to-end anastomosis without interposition graft and evaluated daily for 5 days and after that biweekly by duplex sonography during the follow-up period for 2 months and treated by therapeutic dose of heparin followed by warfarin to maintain INR between 2 to 2.5. The cause of end stage liver disease was hepatitis B in 10, cryptogenic cirrhosis in 7 and other causes in 8. Thrombosis was partial in 16 and near-complete in 9 patients. Extension of thrombosis was through confluence of superior mesenteric and splenic vein in 22 and to superior mesenteric vein in 3 patients. The mean operative time was 7.25 ± 1.27 hours. The transfusion requirement was 5.76 ± 3.28 units packed cell. The mean duration of hospital stay in these patients was 17.72 ± 10.95 days. The mean follow-up period was 11.08 ± 8.74 months. We had 7 mortality cases including 1 early in-hospital PVT and 1 hepatic vein thrombosis, and 1 from in-hospital ischemic cerebrovascular attack despite full anticoagulant therapy. The overall morbidity was 32%. We had no relapse of PVT in the other patients. The presence of PVT at the time of OLT is not a contraindication for OLT but patients with PVT ard facing more difficult surgery, have more postoperative complications, and have higher in-hospital mortality rate.

Volume : 6
Issue : 4
Pages : 75

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Shiraz Transplant Center, and Transplantation Research Center, Shiraz University of Medical Sciences, Shiraz, Iran