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New Thrombectomy Technique for Total Portal Vein Thrombosis in Liver Transplantation
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Nontransplant options for portomesenteric thrombosis
1Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan.
Current Opinion in Organ Transplantation
|February 10, 2022
Summary
Portomesenteric thrombosis (PMT) treatment focuses on anticoagulation for less extensive cases. More advanced PMT or refractory portal hypertension may require transjugular intrahepatic portosystemic shunts.
Area of Science:
- Gastroenterology
- Hepatology
- Vascular Surgery
Background:
- Portomesenteric thrombosis (PMT) is a critical complication, primarily seen in liver transplant candidates with cirrhosis.
- PMT is increasingly recognized following bariatric surgery and in inflammatory bowel disease.
- Existing consensus guidelines inform management strategies.
Purpose of the Study:
- To review current evidence on non-transplant treatment options for portomesenteric thrombosis.
- To discuss updated therapeutic approaches based on recent findings.
Main Methods:
- Literature review of current evidence on PMT treatment.
- Analysis of consensus guidelines and recent publications.
Main Results:
- Anticoagulation is the primary treatment for PMT affecting less than 50% of the main portal vein.
- Transjugular intrahepatic portosystemic shunts are reserved for extensive PMT or refractory portal hypertension.
Conclusions:
- Treatment decisions for PMT are guided by the extent of thrombosis, therapeutic response, and associated complications.
- Updated non-transplant strategies are crucial for managing this condition.
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