肝移植受者急性主要门静脉血栓形成的经皮经脾静脉溶栓治疗：独特经验
Per-Cutaneous Trans-splenic Vein Thrombolysis of Acute Major Portal Vein Thrombosis in Post-Liver Transplant Recipient: A Unique Experience.
作者信息
Dogar A, Ullah K, Uddin Sh, Memon Y, Zafar M, Bilal H, Shoaib A, Ghaffar A, Hasnain S, Soomro Q
机构信息
Liver Transplant and HBP Department, Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Pakistan.
Radiology Unit, Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Pakistan.
出版信息
Int J Organ Transplant Med. 2021;12(3):32-36.
Portal venous thrombosis (PVT) is an uncommon complication in post-liver transplant recipients. The reported incidence is 1-4%. It may occur within a month, called early or after one month of transplantation, known as late PVT. Early PVT has a poor prognosis, leading to graft failure in most cases. Treatment of such cases is quite challenging because of difficult alternative portal inflow establishment. We performed successful thrombolysis of acute major PVT with a unique technique using ultrasound-guided percutaneous trans-splenic vein access in a post-liver transplant recipient. The per-cutaneous trans- splenic vein approach-based thrombolysis described here in this report might be very helpful in similar cases. This technique minimizes the potential risk of graft loss, avoids re-exploration, has a low risk of bleeding, and is cost-effective.
门静脉血栓形成（PVT）是肝移植受者中一种罕见的并发症。报告的发病率为1%-4%。它可能在移植后一个月内发生，称为早期PVT，或在移植一个月后发生，称为晚期PVT。早期PVT预后较差，大多数情况下会导致移植失败。由于难以建立替代门静脉流入，此类病例的治疗颇具挑战性。我们采用独特技术，通过超声引导经皮经脾静脉穿刺，成功地对一名肝移植受者的急性主要PVT进行了溶栓治疗。本报告中描述的基于经皮经脾静脉途径的溶栓治疗可能对类似病例非常有帮助。该技术可将移植丢失的潜在风险降至最低，避免再次手术探查，出血风险低且具有成本效益。
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