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急性门静脉血栓形成后的肝移植:病例报告。

Liver Transplantation After Acute Portal Vein Thrombosis: Case Report.

机构信息

Gastroenterology and Hepatology Unit at Base Hospital, Brasilia, Brazil.

Gastroenterology and Hepatology Unit at Base Hospital, Brasilia, Brazil; Institute of Cardiology and Transplantation of the Federal District (ICTDF), Brasilia, Brazil.

出版信息

Transplant Proc. 2022 Jun;54(5):1365-1369. doi: 10.1016/j.transproceed.2022.04.004. Epub 2022 May 18.

Abstract

BACKGROUND

Portal vein thrombosis is a relatively frequent complication in patients with liver cirrhosis. Its detection and management are essential to avoid worsening portal hypertension or liver function complications. This complication can also negatively impact or even preclude liver transplant.

CASE PRESENTATION

We report the case of a patient who presented with acute portal vein thrombosis, which allowed the diagnosis of liver cirrhosis and hepatocarcinoma within the Milan criteria. Chemical thrombolysis was performed with a mechanical aspiration of the thrombus, and in a second moment, the patient was submitted to a liver transplant.

CONCLUSIONS

Advances in the therapeutic approach to portal vein thrombosis and surgical techniques have allowed the condition to no longer be an absolute contraindication to liver transplantation. Diagnosis in the acute phase is associated with greater therapeutic success, aiming to avoid the extension of thrombosis and achieve portal vein recanalization.

摘要

背景

门静脉血栓形成是肝硬化患者较为常见的并发症。检测和处理门静脉血栓形成对于避免门静脉高压或肝功能并发症的恶化至关重要。该并发症也可能对肝移植产生负面影响,甚至导致其无法进行。

病例介绍

我们报告了一例患者,其因急性门静脉血栓形成就诊,符合米兰标准,诊断为肝硬化和肝癌。采用机械血栓抽吸进行化学溶栓,随后患者接受了肝移植。

结论

门静脉血栓形成的治疗方法和外科技术的进步使得该病症不再是肝移植的绝对禁忌证。在急性期进行诊断与更高的治疗成功率相关,旨在避免血栓延伸并实现门静脉再通。

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