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Successful liver transplantation in a patient with a thrombosed portomesenteric system after multiple failed shunts.
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1991
Year
Solid Organ TransplantationSurgeryPortal Venous InflowHepatobiliary TumorVascular SurgeryRadiologyHealth SciencesTransplantation SurgeryTransplantationLiver PhysiologyLiver TransplantationPortal VeinHepatologyPortomesenteric SystemSuccessful Liver TransplantationHepatitisTransplant SurgeryVascular AccessLiverMedicine
Combined portal and mesenteric vein thrombosis preventing restoration of adequate portal venous flow has been considered a contraindication to liver transplantation. We report a patient with failed splenorenal (SR), portocaval (PC), and mesocaval (MC) shunts, who despite the absence of any obvious means for supplying portal venous inflow to a hepatic graft, successfully underwent orthotopic liver transplantation. A method of reconstruction of the portal vein with the use of vein grafts anastomosed to a large splanchnic venous collateral is described. This technique can be used in selected patients in whom orthotopic liver transplantation might otherwise be considered technically impossible.