Doria Cataldo, Marino Ignazio R
Department of Surgery, Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Int Surg. 2003 Oct-Dec;88(4):184-7.
The incidence of portal vein thrombosis in end-stage liver disease is estimated as varying between 5% and 21%, whereas in candidates undergoing liver transplantation, this is 3-13%. Portal vein thrombosis occurring after liver transplantation can be managed surgically by thrombectomy, retransplantation, splenorenal shunt, or Wall-stent placement, or nonsurgically by angioplasty, local high-dose infusion of thrombolytic agents, combination of portal thrombolysis, or embolization of a pre-existing spontaneous splenorenal shunt. We report a case of portal vein thrombosis after liver transplantation diagnosed on postoperative day 1 in a 57-year-old patient who received a liver from an 8-year-old donor. The patient was successfully treated surgically with portal vein thrombectomy and systemic anticoagulation. Portal vein thrombosis, in this case, was considered to be secondary to size discrepancy between the donor and the recipient portal veins. Routine use of daily Doppler ultrasound was the key factor in early diagnosis.
终末期肝病门静脉血栓形成的发生率估计在5%至21%之间，而在接受肝移植的患者中，这一比例为3%至13%。肝移植后发生的门静脉血栓形成可通过手术进行血栓切除术、再次移植、脾肾分流术或放置Wall支架进行处理，也可通过血管成形术、局部高剂量输注溶栓剂、门静脉溶栓联合或栓塞已存在的自发性脾肾分流术进行非手术处理。我们报告一例肝移植后门静脉血栓形成的病例，该病例于术后第1天在一名57岁接受8岁供体肝脏的患者中被诊断出来。该患者通过门静脉血栓切除术和全身抗凝治疗成功治愈。在这种情况下，门静脉血栓形成被认为是供体和受体门静脉大小差异所致。常规每日使用多普勒超声是早期诊断的关键因素。
