Left branch of portal vein thrombosis in a liver transplant recipient with donation after cardiac death donor: A case report.
Left branch of portal vein thrombosis in a liver transplant recipient with donation after cardiac death donor: A case report.
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心脏死亡供体捐献后肝移植受者出现门静脉左支血栓：病例报告。
DOI：
10.1097/md.0000000000005520
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发表时间：
2016-12
期刊：
影响因子：
1.6
通讯作者：
He X
中科院分区：
文献类型：
--
作者：
Chen M;Ju W;Lin X;Zhao Q;Wang D;He X
门静脉血栓形成（PVT）是肝移植术后最严重的并发症之一，通常会导致移植物丢失和受体死亡。门静脉系统栓塞分支的建立及其结果在文献中没有很好的描述。我们在此报告一例心脏死亡供者原位肝移植后门静脉右支血栓形成的罕见病例，无明显不适。移植后第11天行多普勒超声检查门静脉分支血栓形成，并行血管造影进一步证实。经尿激酶紧急置管溶栓治疗后，疗效改善，肝功能稳定。患者病情缓解22个月，移植物功能正常。在本病例报告中，我们认为在肝移植早期应经常进行超声检查，以发现未阻塞的血管，并可采用局部溶栓治疗，以防止肝损伤并保持血管畅通。
Portal vein thrombosis (PVT) is one of the most severe complications after liver transplantation, which usually causes graft loss and recipient mortality. The founding of the embolic branch of portal system and its result are not well described in the literature. We report here an unusual case of complete right branch thrombosis of portal vein after orthotopic liver transplantation from a donation after cardiac death donor, without obvious malaise. The branch thrombosis of portal vein was detected by Doppler ultrasound 11 days after transplantation, followed by angiography for further verification. After treatment with urgent indwelling catheter thrombolysis with urokinase, results improved and the patient showed stable liver function. The patient has been in remission for 22 months with normal graft function. In this case report, we show that frequent ultrasound inspection should be adopted to detect the unobstructed vessel in the early stage of liver transplantation, and local thrombolytic therapy can be used to prevent liver injury and keep the vessel open.