Portal vein thrombosis and liver transplantation

doi:10.3877/cma.j.issn.1674-3903.2019.03.019

Abstract

Abstract:

Portal vein thrombosis (PVT) is defined as thrombosis in main portal vein and its tributary. Because of lacking specific clinical characteristics, most PVT was detected through imageological examination before transplantation, or discovered by accident during surgery. With rapid development of liver transplantation in China, more liver transplantation recipients with PVT were found during transplantation, and PVT is no longer the contraindication of liver transplantation. Therefore, reasonable diagnosis and treatment, and effective management during transplantation aiming at PVT is important. This review will elucidate the recent domestic and international progress in the aspect of PVT in liver transplantation.

Key words: Liver transplantation, Portal vein thrombosis, Diagnosis, Classification, Reconstruction of portal vein

Fangzhou Luo, Zhe Yang, Shusen Zheng. Portal vein thrombosis and liver transplantation[J]. Chinese Journal of Transplantation(Electronic Edition), 2019, 13(03): 245-251.

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References 69

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文献	Ⅰ级	Ⅱ级	Ⅲ级	Ⅵ级
Yerdel等^[2]	门静脉阻塞程度<50%，远端肠系膜上静脉通畅	门静脉阻塞程度>50%，远端肠系膜上静脉通畅	门静脉完全栓塞，肠系膜近端血栓栓塞，肠系膜静脉远端尚通畅	门静脉主干和肠系膜上静脉管腔完全栓塞
Stieber等^[21]	血栓仅限于门静脉主干，无论阻塞程度	血栓蔓延至肠系膜上静脉，脾静脉尚通畅	门静脉完全栓塞且血栓蔓延至脾静脉和肠系膜上静脉通畅	门静脉、脾静脉和肠系膜上静脉均完全栓塞
Kim等^[22]	PVT位于肠系膜上静脉与脾静脉汇合点上	PVT蔓延至肠系膜上静脉与脾静脉汇合点下，远端肠系膜上静脉尚通畅	PVT蔓延至远端肠系膜上静脉，伴冠状静脉侧支形成	门静脉主干、肠系膜上静脉和脾静脉完全血栓栓塞，冠状静脉血栓形成
Bauer等^[23]	门静脉阻塞程度≤25%	门静脉阻塞程度26%～50%	门静脉阻塞程度51%～75%	门静脉阻塞程度>75%
Charco等^[24]	血栓仅限于门静脉(包括部分与完全阻塞)	血栓蔓延至肠系膜上静脉近端，可再通	弥漫性血栓形成伴侧支循环扩张	弥漫性血栓形成，不伴侧支循环扩张
Jamieson等^[25]	血栓仅限于门静脉与肠系膜汇合处上，无论阻塞程度	血栓蔓延至肠系膜上静脉内，但肠系膜上静脉尚通畅	弥漫性血栓形成，但具有较大的侧支循环	弥漫性血栓形成，伴纤细的侧支循环

文献	Ⅰ级	Ⅱ级	Ⅲ级	Ⅵ级
Yerdel等^[2]	门静脉阻塞程度<50%，远端肠系膜上静脉通畅	门静脉阻塞程度>50%，远端肠系膜上静脉通畅	门静脉完全栓塞，肠系膜近端血栓栓塞，肠系膜静脉远端尚通畅	门静脉主干和肠系膜上静脉管腔完全栓塞
Stieber等^[21]	血栓仅限于门静脉主干，无论阻塞程度	血栓蔓延至肠系膜上静脉，脾静脉尚通畅	门静脉完全栓塞且血栓蔓延至脾静脉和肠系膜上静脉通畅	门静脉、脾静脉和肠系膜上静脉均完全栓塞
Kim等^[22]	PVT位于肠系膜上静脉与脾静脉汇合点上	PVT蔓延至肠系膜上静脉与脾静脉汇合点下，远端肠系膜上静脉尚通畅	PVT蔓延至远端肠系膜上静脉，伴冠状静脉侧支形成	门静脉主干、肠系膜上静脉和脾静脉完全血栓栓塞，冠状静脉血栓形成
Bauer等^[23]	门静脉阻塞程度≤25%	门静脉阻塞程度26%～50%	门静脉阻塞程度51%～75%	门静脉阻塞程度>75%
Charco等^[24]	血栓仅限于门静脉(包括部分与完全阻塞)	血栓蔓延至肠系膜上静脉近端，可再通	弥漫性血栓形成伴侧支循环扩张	弥漫性血栓形成，不伴侧支循环扩张
Jamieson等^[25]	血栓仅限于门静脉与肠系膜汇合处上，无论阻塞程度	血栓蔓延至肠系膜上静脉内，但肠系膜上静脉尚通畅	弥漫性血栓形成，但具有较大的侧支循环	弥漫性血栓形成，伴纤细的侧支循环

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