Liver transplant in patients with portal vein thrombosis: Medical and surgical requirements
Liver transplant in patients with portal vein thrombosis: Medical and surgical requirements
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DOI：
10.1002/lt.24856
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发表时间：
2017-10-01
影响因子：
4.6
通讯作者：
Pomfret, Elizabeth A.
中科院分区：
文献类型：
--
作者：
Conzen, Kendra D.;Pomfret, Elizabeth A.
3.移植前患者的PVT管理选项包括抗凝、TIPS和通过系列影像学研究进行频繁监测。4.外翻血栓切除术或血栓静脉切除术（伴或不伴自发性门体分流结扎）可用于重建门静脉血栓患者肝移植期间的门静脉血流。在门静脉海绵样变性或涉及脾-SMV汇合处的闭塞性PVT患者中，可以通过胆总管周围静脉曲张或扩大的冠状静脉、SMV-PV跳跃移植、肾门静脉吻合或腔门静脉半转位建立肝移植物的静脉流入。
3. Options for management of PVT in the pretransplant patient include anticoagulation, TIPS, and frequent monitoring with serial imaging studies. 4. Eversion thrombectomy or thrombendvenectomy, with or without ligation of spontaneous portosystemic shunts, may be used to re-establish portal venous flow during liver transplant in patients with PVT. 5. In patients with cavernous transformation of the portal vein or occlusive PVT involving the splenic-SMV confluence, venous inflow to the liver allograft can be established through a pericholedochal varix or enlarged coronary vein, SMV-PV jump graft, renoportal anastomosis, or cavoportal hemitransposition.