Direct transmesenteric venous interventions in the acute post liver transplant setting

Portal venous thrombosis and stenosis are uncommon but serious causes of liver transplant graft failure. While surgical thrombectomy can be utilized for the treatment of portal steno-occlusive disease, venous interventions with IR have been performed with encouraging results.

69-year-old female with non-alcoholic steatohepatitis cirrhosis who received a liver transplant complicated by portal vein thrombus. Efforts between transplant surgery and IR allowed for successful thrombus removal via direct SMV access.

The advantages of direct SMV access with the surgery team include direct approach to accessing thrombus, sparing of liver parenchyma, and significant hemostatic control.