TY  - CHAP
M1  - Book, Section
TI  - Portal Vein Thrombosis
A1  - McCormack, Lucas
A1  - Devoto, Jorge
A2  - Molmenti, Ernesto Pompeo
A2  - Santibañes, Martin de
A2  - Santibañes, Eduardo de
PY  - 2021
T2  - Liver Transplantation: Operative Techniques and Medical Management
AB  - Although  the  surgical  technique  of  liver  transplantation  (LT)  has  emerged  from  an  experimental  therapy  to  a  more  standardized  and  relatively  safe  procedure,  great  differences  exist  in  the  complexity  of  the  operation  among  different  patients.  Venous  abnormalities  are  a  relatively  frequent  finding.  These  abnormalities  include  acute  and  chronic  portal  vein  thrombosis  (PVT).  The  incidence  of  PVT  in  patients  undergoing  orthotopic  liver  transplantation  (OLT)  ranges  from  2.1%  to  26%  in  a  large  reported  series.  During  LT,  it  may  be  difficult  to  reconstitute  adequate  portal  venous  inflow  to  the  graft  in  these  patients.  In  the  1980s,  PVT  was  considered  an  absolute  contraindication  to  OLT.  In  2000,  Yerdel  et  al.  proposed  a  grading  system  for  PVT  (Table  73-1,  Fig.  73-1).  Grade  1  involves  less  than  50%  of  the  portal  vein  (PV)  lumen  with  or  without  minimal  extension  into  the  superior  mesenteric  vein  (SMV)  (Fig.  73-2).  With  grade  2,  more  than  50%  occlusion  of  the  PV  is  present,  including  total  occlusion,  with  or  without  minimal  extension  into  the  SMV  (Fig.  73-3).  Grade  3  involves  complete  thrombosis  of  both  the  PV  and  the  SMV  trunk  (distal  SMV  patent)  (Fig.  73-4).  Grade  4  involves  complete  thrombosis  of  both  the  PV  and  SMV  (Fig.  73-5).  Several  surgical  techniques  have  been  described  to  deal  with  portal  or  mesenteric  vein  thrombosis.1–3  
SN  - 
PB  - McGraw Hill
CY  - New York, NY
Y2  - 2024/04/19
UR  - accesssurgery.mhmedical.com/content.aspx?aid=1180112916
ER  -