Interventional Treatment of Severe Portal Vein Thrombosis after Living-Donor Liver Transplantation

Youichi Kawano; Satoru Murata; Nobuhiko Taniai; Masato Yoshioka; Atsushi Hirakata; Yoshiaki Mizuguchi; Tetsuya Shimizu; Tomohiro Kanda; Junji Ueda; Hideyuki Takada; Hiroshi Yoshida; Koho Akimaru; Shiro Onozawa; Shinichirou Kumita; Eiji Uchida

doi:10.1272/jnms.83.206

Case Reports

Interventional Treatment of Severe Portal Vein Thrombosis after Living-Donor Liver Transplantation

Youichi Kawano, Satoru Murata, Nobuhiko Taniai, Masato Yoshioka, Atsushi Hirakata, Yoshiaki Mizuguchi, Tetsuya Shimizu, Tomohiro Kanda, Junji Ueda, Hideyuki Takada, Hiroshi Yoshida, Koho Akimaru, Shiro Onozawa, Shinichirou Kumita, Eiji Uchida

Author information

Youichi Kawano
Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School
Satoru Murata
Department of Radiology, Nippon Medical School
Nobuhiko Taniai
Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School
Masato Yoshioka
Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School
Atsushi Hirakata
Department of Surgery, Nippon Medical School Tama Nagayama Hospital
Yoshiaki Mizuguchi
Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School
Tetsuya Shimizu
Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School
Tomohiro Kanda
Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School
Junji Ueda
Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School
Hideyuki Takada
Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School
Hiroshi Yoshida
Department of Surgery, Nippon Medical School Tama Nagayama Hospital
Koho Akimaru
Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School
Shiro Onozawa
Department of Radiology, Nippon Medical School
Shinichirou Kumita
Department of Radiology, Nippon Medical School
Eiji Uchida
Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School

Keywords: living-donor liver transplantation, portal vein thrombosis, complication, interventional treatment

JOURNAL FREE ACCESS

2016 Volume 83 Issue 5 Pages 206-210

DOI https://doi.org/10.1272/jnms.83.206

Details

Abstract

Portal vein thrombosis (PVT) is a rare complication of liver transplantation which can lead to graft failure and patient death. Treatment can be difficult, especially in cases of PVT from the intrahepatic portal vein to the proximal jejunal veins. A 55-year-old woman had undergone living-donor liver transplantation with splenectomy for end-stage liver cirrhosis due to hepatitis C with hepatocellular carcinoma. Ten months after transplantation, massive ascites and slight abdominal pain developed, and computed tomography revealed a PVT between the intrahepatic portal vein and the superior mesenteric vein. Repeated interventional radiology procedures were used in combination with thrombolysis, thrombectomy, and metallic stent replacement to obtain favorable portal flow to the graft. Five years after being treated, the patient is well, with favorable portal flow having been confirmed. In conclusion, repeated and assiduous interventional radiological treatment combined with thrombolytic therapy, thrombectomy, and metallic stent replacement could be important for severe PVT.

Corresponding author

Register with J-STAGE for free!