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Updated: Aug 5, 2026
New Thrombectomy Technique for Total Portal Vein Thrombosis in Liver Transplantation
Published on: June 27, 2025
Does Venous Drainage Route Matter? Portal Versus Systemic Drainage in Isolated Intestinal Transplantation: An
Vighnesh Venkatasamy1, Amay Banker1, Mahmoud Morsi1
1Department of Surgery, Division of Transplant Surgery, University of Miami/Jackson Health System, Miami, Florida, USA.
Background:
Type of venous drainage in isolated intestinal transplantation (ITx) may influence immune responses through hepatic filtration of gut-derived antigens and affect outcomes.
Methods:
We analyzed United Network for Organ Sharing data from 2013-2023 to compare portal versus systemic drainage in pediatric and adult ITx recipients. Graft and patient survival were assessed using Kaplan-Meier and Cox proportional hazards models, and acute rejection during the index admission was evaluated with multivariable logistic regression.
Results:
Among 480 recipients (137 pediatric, 343 adult), systemic drainage in pediatric patients was associated with higher acute rejection rates (50.7% vs. 32.4%, p = 0.029), and adjusted analysis confirmed systemic drainage as an independent risk factor (OR 2.32, 95% CI 1.00-5.37, p = 0.049). No survival differences were observed between drainage types in either age group.
Conclusion:
While venous drainage type did not affect long-term graft or patient survival, portal drainage in pediatric ITx was associated with lower odds of early acute rejection, suggesting a potential immunologic benefit that warrants prospective validation.
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