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New Thrombectomy Technique for Total Portal Vein Thrombosis in Liver Transplantation
Published on: June 27, 2025
Multivisceral transplantation for diffuse portomesenteric thrombosis.
Rodrigo M Vianna1, Richard S Mangus, Chandrashekhar Kubal
1Department of Surgery, Division of Transplantation, Indiana University School of Medicine, Indianapolis, IN 46202, USA. rvianna@iupui.edu
Annals of Surgery
|May 3, 2012
Summary
Multivisceral transplantation (MVT) offers a viable treatment for diffuse portomesenteric thrombosis (PMT), demonstrating good patient and graft survival. This approach effectively resolves portal hypertension, outperforming alternative methods.
Area of Science:
- Gastroenterology
- Transplant Surgery
- Vascular Surgery
Background:
- Diffuse portomesenteric thrombosis (PMT) poses challenges for liver transplantation (LT).
- Standard LT and alternative techniques like portocaval hemitransposition may not fully resolve portal hypertension complications.
- Multivisceral transplantation (MVT) addresses both the liver and the thrombosed portomesenteric system.
Purpose of the Study:
- To assess the clinical outcomes of multivisceral transplantation (MVT) in patients with diffuse portomesenteric thrombosis (PMT).
Main Methods:
- Prospective analysis of a database of intestinal transplant patients.
- Diagnosis of diffuse PMT confirmed via dual-phase abdominal CT or MRI with venous reconstruction.
- Evaluation of 25 patients undergoing MVT, with 11 also receiving simultaneous kidney transplants.
Main Results:
- Excellent patient and graft survival rates at 1, 3, and 5 years (80%, 72%, 72% median follow-up 2.8 years).
- Successful treatment of acute cellular rejection in 5 recipients.
- All survivors exhibit good graft function with complete resolution of portal hypertension.
Conclusions:
- Multivisceral transplantation (MVT) is a promising option for diffuse portomesenteric thrombosis (PMT).
- MVT is the sole procedure capable of completely reversing portal hypertension.
- MVT achieves superior survival outcomes compared to alternative treatments for PMT.
