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  • Title: Salvage procedure for unexpected portal vein thrombosis in living donor liver transplantation.
    Author: Maluf D, Shim I, Posner M, Cotterell AH, Fisher RA.
    Journal: Transplant Proc; 2006 Jun; 38(5):1422-4. PubMed ID: 16797321.
    Abstract:
    Portal vein thrombosis (PVT) is considered a relative contraindication to living donor liver transplantation (LDLTx) due to technical difficulty and ethical considerations. So far, there have been a few reported cases of LDLTx with PVT, most of which were treated by thrombectomy with or without a venous conduit. We report a case of LDLTx in an unexpected recipient with grade 4 diffuse PVT, which was successfully managed using a variceal left gastric vein and a deceased donor iliac vein conduit to create a "de novo portal vein" for splanchnic inflow to the right lobe. The patient experienced an uneventful postoperative course with normal blood flow in the de novo portal vein at 1-year follow up. This report demonstrated that a variceal collateral vein can be used as appropriate alternative inflow for the right lobe in LDLTx cases in which an unexpected PVT is encountered.
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