The management and outcomes of De Novo Portal Vein thrombosis following liver transplantation - 02/03/26
, Maggie Minett a, Neeta Vachharajani a, Jesse Smith b, Su-Hsin Chang c, Yikyung Park c, Adeel S Khan a, MB Majella Doyle a, William C Chapman a
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Highlights |
• | De novo portal venous thrombosis can compromise long term allograft outcomes. |
• | Complete resolution can be successfully achieved with medical management only. |
• | Surgical interventions should be reserved for early thrombosis with threatened grafts. |
Abstract |
Aim |
While portal vein thrombosis (PVT) is well described in patients with cirrhosis, no guidance on de-novo cases following liver transplantation (LT) exists. We describe our experience with new-onset PVT in liver allografts post-LT.
Methods |
Transplant recipients between 2002 and 2024 were reviewed from an institutional database excluding patients with pre-LT PVT. Early (<30 days) and late (>30 days of LT) PVT was defined accordingly.
Results |
Out of 2273 LTs, PVT occurred in 32 recipients (age 51 ± 11 years; early n = 15; late n = 17). Median time to PVT was 42 days (range 3– 5042 days).
Complete thrombus resolution was achieved following re-transplantation ( n = 4) and surgical thrombectomy ( n = 3). Venoplasty ( n = 1) and stenting ( n = 1) were performed for late PVT events. Using anticoagulation-only strategies, complete resolution was achieved in 16/17 recipients. The remaining 6 did not receive any medical or surgical intervention.
Both 1-, 3- and 5-year overall ( p < 0.05) and graft survival ( p = 0.02) were lower in LT recipients with de novo PVT when compared to non-PVT cases.
Discussion |
Although infrequent, PVT post-LT is a difficult clinical scenario with no clear treatment algorithm in the transplant literature. Non-operative management is feasible, however, surgical and radiological interventions are merited for LT recipients with compromised allograft function.
Le texte complet de cet article est disponible en PDF.Key words : Portal vein thrombosis, Allograft thrombosis, Liver venous thrombosis
Abbreviations : BMI, CRLM, DBD, DCD, EBL, HA, HAT, HCC, ICU, LOS, LT, MELD, NASH, NMP, OS, PSC, PVT, TIPS
Plan
Vol 22
Article 100335- mai 2026 Retour au numéro
Article précédent
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