Copyright © 2011, the Korean Surgical Society
J Korean Surg Soc 2011;81:35-42
Journal of the Korean Surgical Society
pISSN 2233-7903ㆍeISSN 2093-0488
Received October 29, 2010, Accepted May 17, 2011
Correspondence to: Dong Lak Choi
Division of Hepatobiliary and Transplantation Surgery, Department of Surgery, Catholic University of Daegu School of Medicine, 3056-6
Daemyeong 4-dong, Nam-gu, Daegu 705-718, Korea
Tel: ＋82-53-650-4063, Fax: ＋82-53-650-4950, E-mail: firstname.lastname@example.org
cc Journal of the Korean Surgical Society is an Open Access Journal. All articles are distributed under the terms of the Creative Commons
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An early single-center experience of portal vein
thrombosis in living donor liver transplantation:
clinical feature, management and outcome
Joo Dong Kim, Dong Lak Choi, Young Seok Han
Division of Hepatobiliary and Transplantation Surgery, Department of Surgery, Catholic University of Daegu School of Medicine,
Purpose: Portal vein thrombosis (PVT) has been considered a relative contraindication for living donor liver transplantation
(LDLT). However, it is no longer a contraindication of LDLT due to improvement in surgical techniques and approaches to
PVT. The aim of this study was to assess the impact of PVT on outcomes in LDLT patients. Methods: We retrospectively ana-
lyzed the data from 97 adult patients undergoing LDLT in our center from July 2008 to June 2010. Intraoperative findings and
preoperative imaging results were reviewed for PVT grading (Yerdel grading). We analyzed the technical aspects and com-
parisons of risk factors, perioperative variables, and survivals between patients with and without PVT based on the grades.
Results: In the 97 LDLT patients, 18 patients were confirmed to have PVT (18.5%) including grade I cases (n = 8), grade II (n =
7), and grade III (n = 3). Prior treatment of portal hypertension was found to be an independent risk factor for PVT (P = 0.001).
The comparisons between PVT and no PVT groups showed no significant difference in intraoperative and postoperative var-
iables except for postoperative bleeding (P = 0.036). The short-term portal vein patency, in-hospital mortality and survival
rates were not significantly different between the PVT and control groups. Conclusion: The outcomes are similar to non-PVT
group in terms of in-hospital mortality, survival rates, and postoperative complications. Therefore, our study suggests that
PVT cannot be considered to be a contraindication for LDLT and LDLT could be undertaken without increased morbidity
and mortality in patients with PVT, in spite of operative complexity.
Key Words: Portal vein, Thrombosis, Liver transplantation, Outcome assessment
In the early period of liver transplantation (LT), portal
vein thrombosis (PVT) was considered a contraindication
for operation because of the technical difficulties it en-
tailed, especially the inability to gain an adequate portal
supply [1-3]. In 1985, Shaw et al.  reported the first suc-
cessful deceased donor liver transplantation (DDLT) for a
PVT patient and since then, many innovative surgical
techniques have been introduced such as thrombectomy,
portal vein (PV) reconstruction using vein grafts, and cav-
oportal hemitransposition [5-9]. Current PVT patients are
no longer regarded to be contraindicated for LT and the re-
sults for patients with PVT is now comparable to that of
Joo Dong Kim, et al.
CONFLICTS OF INTEREST
No potential conflict of interest relevant to this article
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