[Early thrombosis of the portal vein after orthoptic liver transplantation. A case report].

Abstract

We report on a case of early portal vein thrombosis occurring after liver transplantation in a patient with alcoholic cirrhosis. Although this complication is usually accompanied by acute graft failure and/or gastroesophageal bleeding, in this patient the portal thrombosis occurred with the appearance of general dropsy and encephalopathy, serum protein deficiency and a slight rise in liver function test values. Echo-Doppler and arteriography showed portal thrombosis, arterial hyperflow and the persistence of a large spontaneous spleno-renal shunt, identified before the transplant had taken place. Endoscopy did not reveal gastroesophageal varices. Since there was no sign of serious ischemic damage or of a serious deterioration of liver function, the patient was treated non-operatively. Some particular hemodynamic aspects implicated in the appearance of portal thrombosis in our case are discussed. However, the authors consider that spontaneous portal-systemic shunt, in the presence of advanced cirrhosis, inverted portal flow, without gastroesophageal varices, can be considered as a surgical total diverting shunt and should be taken as a risk for portal thrombosis after transplantation.

• Authors: A Recordare, R Bellusci, S Gaiani, A Cavallari, G Gozzetti
• Journal: Minerva chirurgica (Minerva Chir) Vol. 48 Issue 8 Pg. 425-30 (Apr 30 1993) ISSN: 0026-4733 [Print] Italy
• Vernacular Title: Trombosi precoce della vena porta dopo trapianto ortotopico di fegato. Descrizione di un caso.
• PMID: 8321440 (Publication Type: English Abstract, Journal Article)

Topics

• Diabetes Mellitus, Type 1 (complications, surgery)
• Humans
• Liver Cirrhosis, Alcoholic (complications, surgery)
• Liver Transplantation
• Male
• Middle Aged
• Portal Vein
• Portasystemic Shunt, Surgical
• Postoperative Complications (diagnosis, surgery)
• Thrombosis (diagnosis, surgery)
• Time Factors
• Transplantation, Homologous