Ten‐Year Experience in Porto‐Caval Hemitransposition for Liver Transplantation in the Presence of Portal Vein Thrombosis

摘要: Porto-caval hemitransposition (PCH) in liver transplantation allows revascularization of the when porto-mesenteric axis is thrombosed. We, here, review our experience over an 11-year period. A total 23 patients underwent using PCH. Immunosuppression was based on tacrolimus, with sirolimus used case renal insufficiency. Most common diagnoses were hepatitis C, Laennec's, Budd-Chiari and cryptogenic cirrhosis. Six needed splenectomy prior to transplant, 5 during 1 post-transplant, 11 had no splenectomy. Overall survival 60% at year 38% 3 years, 10 currently alive longest survivor 9.3 years. cause death sepsis/multisystem organ failure, followed by pulmonary embolism. 7/23 experienced post-operative gastrointestinal bleeding episodes, 6/23 developed thrombosis vena cava (median 162 days post-op). Post-operative ascites noted almost all patients. Renal dysfunction commonly seen even after first month post-transplant. PCH offers a feasible option for those complex mesenteric portal circulation.