Portomesenteric Jump Graft for Liver Transplantation. Single Center Experience in Latin America

Chronic portal vein thrombosis and cavernomatosis are a complex challenge for liver transplantation. This study aims to analyze the results of portomesenteric reconstruction with a jump graft using the cadaveric iliac vein in liver transplantation.

Non-concurrent cohort study from 2001 to 2023. All patients who underwent portal vein reconstruction with a mesenteric jump graft for liver transplantation were included.

Nineteen patients were included. Pretransplant diagnosis of portal vein thrombosis was in 13 patients (68,4%), with 7 of them (36.8%) receiving anticoagulation. A preoperative decision to perform the venous jump graft was made in 8 patients (42.1%). Intraoperatively, 11 patients were classified as grade III according to the Yerdel classification, and eight were found to have cavernomatosis. Eleven patients (57.9%) experienced major complications, with 7 patients requiring reoperation. None of the complications were related to the portomesenteric jump graft. Two patients (10,5%) died in the first 30 days. The 5-year overall and graft survival rates were identical at 63.2%, as no retransplantations occurred. The median follow-up for venous bridge patency was 18 months, identifying only 2 thrombosed bridges (13.3%).

Portomesenteric reconstruction with a jump graft using a cadaveric iliac vein yields favorable outcomes in this cohort of liver transplantations. This technique represents a vital surgical strategy, enabling transplantation for patients who would otherwise not be considered transplant candidates.