Detailed Abstract
[Liver Best Video Presentation - Liver (Transplantation)]
[LV BV 6] UNIQUE MULTIDISCIPLINARY APPROACH IN LDLT TO ACHIEVE TOTAL PHYSIOLOGICAL REVASCULARIZATION IN A PATIENT WITH COMPLETE OCCLUSION OF PORTAL VEIN SYSTEM WITH COMBINED CHRONIC AND SUB-ACUTE THROMBOSIS
Jae-Yoon KIM 1, Kwang-Woong LEE 1, Francesca ALBANESI 2, YoungRok CHOI 1, Nam-Joon YI 1, Kyung-Suk SUH 1
1 Hepatobiliary Surgery, Seoul National University Hospital, Korea, 2 General Surgery And Liver Transplantation Unit, National Cancer Institute, University of Milan, Italy
Background : Patients receiving liver transplantation in a setting of complete portal vein (PV) and superior mesenteric vein (SMV) thrombosis (Yerdel grade 4) experience lower outcomes after surgery; prognosis is independently influenced by the portal flow reconstruction technique, showing better outcomes in physiological surgical strategies.
Methods : We describe a case of living donor liver transplantation in which the patient could not receive common physiological reconstructions pre-operatively due to multiple small collaterals and extensive thrombosis down to 1st branches of SMV. We performed thrombo-endo-venectomy of the portal vein and SMV first, but acute thrombosis developed recurrently even with interposition venous homograft between peri-choledochal collateral vein and proximal recipient portal vein.
Results : Immediate after surgery, intervention radiologist performed stenting insertion into 3 stenotic points.
Conclusions : Through multidisciplinary approach, complete physiologic recanalization was obtained with normal liver function.
Methods : We describe a case of living donor liver transplantation in which the patient could not receive common physiological reconstructions pre-operatively due to multiple small collaterals and extensive thrombosis down to 1st branches of SMV. We performed thrombo-endo-venectomy of the portal vein and SMV first, but acute thrombosis developed recurrently even with interposition venous homograft between peri-choledochal collateral vein and proximal recipient portal vein.
Results : Immediate after surgery, intervention radiologist performed stenting insertion into 3 stenotic points.
Conclusions : Through multidisciplinary approach, complete physiologic recanalization was obtained with normal liver function.
SESSION
Liver Best Video Presentation
Room 1 3/29/2025 8:30 AM - 9:30 AM