Nonami T, Yokoyama I, Iwatsuki S, Starzl T E
Transplantation Institute, University of Pittsburgh School of Medicine, Pennsylvania.
Hepatology. 1992 Nov;16(5):1195-8.
The incidence of portal vein thrombosis was examined in 885 patients who received orthotopic liver transplantations for various end-stage liver diseases between 1989 and 1990. The thrombosis was classified into four grades. Grade 1 was thrombosis of intrahepatic portal vein branches, grade 2 was thrombosis of the right or left portal branch or at the bifurcation, grade 3 was partial obstruction of the portal vein trunk, and grade 4 was complete obstruction of the portal vein trunk. Among the 849 patients without previous portosystemic shunt, 14 patients (1.6%) had grade 1, 27 patients (3.2%) had grade 2, 27 patients (3.2%) had grade 3 and 49 patients (5.8%) had grade 4 portal vein thrombosis. The incidence of portal vein thrombosis was highest (34.8%) in the patients with hepatic malignancy in the cirrhotic liver, followed by those with Budd-Chiari syndrome (22.2%) and postnecrotic cirrhosis of various causes (15.7%). The patients with encephalopathy, ascites, variceal bleeding, previous splenectomy and small liver had significantly higher incidences of portal vein thrombosis than the others. The total incidence of portal vein thrombosis among the 36 patients with previous portosystemic shunt was 38.9%, which was significantly higher than that (13.8%) of those without shunt.
对1989年至1990年间因各种终末期肝病接受原位肝移植的885例患者进行了门静脉血栓形成发生率的研究。血栓形成分为四个等级。1级为肝内门静脉分支血栓形成，2级为右或左门静脉分支或其分叉处血栓形成，3级为门静脉主干部分阻塞，4级为门静脉主干完全阻塞。在849例既往未行门体分流术的患者中，14例（1.6%）为1级，27例（3.2%）为2级，27例（3.2%）为3级，49例（5.8%）为4级门静脉血栓形成。肝硬化肝脏合并肝恶性肿瘤的患者门静脉血栓形成发生率最高（34.8%），其次是布-加综合征患者（22.2%）和各种原因导致的坏死后肝硬化患者（15.7%）。有脑病、腹水、静脉曲张出血、既往脾切除术及肝脏较小的患者门静脉血栓形成发生率显著高于其他患者。36例既往行门体分流术的患者门静脉血栓形成总发生率为38.9%，显著高于未行分流术患者的发生率（13.8%）。
