Venous Inflow Reconstruction During Liver Transplantation in Patients With Portal Vein Thrombosis

O. Yu.  Usenko; O. V.  Hrynenko

doi:10.63181/2788-4740.4.1.2026.20-28

O. Yu. Usenko State institute "Shalimov's national scientific center of surgery and transplantation to National academy of medical sciences of Ukraine” https://orcid.org/0000-0003-4957-4104
O. V. Hrynenko State institute "Shalimov's national scientific center of surgery and transplantation to National academy of medical sciences of Ukraine” https://orcid.org/0000-0003-3535-8232

DOI: https://doi.org/10.63181/2788-4740.4.1.2026.20-28

Keywords: liver transplantation, portal vein thrombosis, vasculobiliary injury

Abstract

Background. Liver transplantation is the only treatment for patients with decompensated end-stage liver disease. Recipient portal vein thrombosis is associated with increased mortality risks both pre- and post-transplant, and is associated with higher technical complexity of the surgical procedure.

The aim of this study is to conduct a retrospective analysis of vascular inflow reconstruction during liver transplantation in the setting of portal vein thrombosis.

Materials and methods. From December 2019 to February 2026, 9 liver transplants were performed in recipients with portal thrombosis in the Department of liver transplantation and surgery of State institute "Shalimov's national scientific center of surgery and transplantation to National academy of medical sciences of Ukraine”. The general characteristics of the patients, the indicators of postoperative complications and mortality were studied.

Results. In all cases, physiological reconstruction of the vascular venous inflow was performed, in 6 cases in the form of eversion thrombectomy from the portal vein with subsequent end-to-end anastomosis, in 2 cases – interpositional jump graft between the portal vein and the superior mesenteric vein, in 1 case – reno-portal shunting. Clinically significant postoperative complications were noted in 3 recipients, 1 patient died on the 51 postoperative day from septic complications.

Conclusions. Portal vein thrombosis in a potential liver recipient requires an individual and variable approach to performing venous vascular inflow reconstruction in liver transplantation based on both anatomical and physiological and hemodynamic characteristics.

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