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Portosystemic shunt for the treatment of portal vein thrombosis following orthotopic liver transplantation
Authors:K Tepetes  A Tzakis  E Tzoracoleftherakis  T Starzl
Institution:University of Pittsburgh Medical Center, Department of Surgery, Division of Transplantation Surgery, 3601 Fifth Avenue, Pittsburgh, PA 15213, USA
Abstract:Abstract The efficacy of the portosystemic shunt operation for the treatment of portal vein thrombosis following orthotopic liver transplantation was demonstrated. From 1 July 1988 to 31 December 1991 42 portosystemic shunt operations were performed at our centre. In six of these cases portal vein thrombosis after orthotopic liver transplantation (OLT) was the indication for the procedure. All the patients retained adequate liver function but they demonstrated manifestations of significant portal hypertension, mainly variceal rebleeding. Two of the patients were children. Three patients underwent distal splenorenal shunt (DSRS), one mesocaval and one side-to-ide splenorenal shunt and the last one side-to-ide splenorenal shunt which was converted to DSRS 2 weeks later. All these patients were doing well after 30 months mean follow-up time without rebleeding or other signs of portal hypertension and none had so far required retransplantation.
Keywords:Key words Portal hypertension  Portosystemic shunt  Liver transplantation
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