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New Thrombectomy Technique for Total Portal Vein Thrombosis in Liver Transplantation
Published on: June 27, 2025
Vascular complications in hepatic transplantation: single-center experience in 14 years
1Department of Internal Medicine, Florence Nightingale Hospital, Istanbul, Turkey. elifakun@hotmail.com
Insights
Timely diagnosis and management of liver transplant vascular complications, such as hepatic artery thrombosis and portal vein thrombosis, significantly reduced mortality rates in this 14-year study.
Area of Science:
- Hepatology
- Vascular Surgery
- Transplant Surgery
Background:
- Liver transplantation is a complex procedure with potential for vascular complications.
- Vascular complications can significantly impact patient outcomes and graft survival.
Purpose of the Study:
- To evaluate the spectrum of liver transplantation-related vascular complications.
- To assess the clinical outcomes of these complications over a 14-year period.
- To determine the impact of timely diagnosis and management on mortality rates.
Main Methods:
- Retrospective review of 744 liver transplant recipients.
- Analysis of vascular complications and their clinical outcomes.
- Correlation of Doppler ultrasound findings with conventional or computed tomography angiography (CTA) in 111 patients.
Main Results:
- Vascular complications occurred in 9% of recipients (70 patients).
- Hepatic artery thrombosis (14/26 treated) had a mortality rate of 23% (6/26) after thrombectomy and reanastomosis.
- Portal vein thrombosis (16/20 treated) had a mortality rate of 10% (2/20) after thrombectomy.
- Hepatic vein stenosis treated with angioplasty or stenting had a mortality rate of 14% (1/7).
Conclusions:
- Timely diagnosis and management of liver transplantation-related hepatic vascular complications are associated with a low mortality rate.
- Vigilant monitoring and prompt intervention are crucial for improving outcomes in liver transplant recipients.
- The study highlights the importance of a multidisciplinary approach in managing these complex cases.
Purpose:
To evaluate the spectrum of liver transplantation-related vascular complications that occurred in a single center over the past 14 years.
Materials And Methods:
Vascular complications and their clinical outcomes were reviewed among 744 liver transplant recipients. All patients underwent Doppler ultrasound with findings correlated with conventional or computed tomography angiography (CTA) in 111 patients.
Results:
Among 70 recipients with vascular complications (%0.9), 14/26 patients with hepatic artery thrombosis underwent thrombectomy and arterial reanastomosis; six were retransplanted and six died. Among hepatic artery stenoses, three of nine were treated with balloon angioplasty and six underwent reanastomosis. Among 20 portal vein thromboses, 16 underwent thrombectomy, two patients retransplantation and two died. Seven patients with portal vein stenosis were followed. Two of six hepatic vein stenosis were restored with balloon angioplasty and three patients with metallic stent placement; the one other died. One patient with hepatic vein thrombosis died while the other patient was retransplanted.
Conclusion:
Transplantation related hepatic vascular complications diagnosed and managed in timely fashion showed a low mortality rate in our series.
