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| Combination of renoportal anastomosis and inferior mesenteric vein-portal anastomosis in liver transplantation: A new portal reconstruction technique |
| Guo-Ling Lin a , # , Min Xiao a , # , Li Zhuang a , Yu Yang a , Qi-Yong Li a , Jian-Fang Lu b , Meng-Xia Li c , Shu-Sen Zheng a , d , ∗ |
a Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College, Hangzhou, China
b Division of Hepatobiliary and Pancreatic Surgery, Department of Nursing, Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College, Hangzhou, China
c Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Zhejiang University School of Medicine, Hangzhou, China
d Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China |
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Abstract Liver transplantation (LT) is the only way to cure end-stage liver disease with or without tumors in the last few decades [1]. However, critical issues such as how to rebuild portal flow in patients with portal vein thrombosis (PVT) or superior mesenteric vein (SMV) thrombosis have been challenging for surgeons. Adequate portal flow is critical in LT because more than 75% of the liver’s blood supply comes from the portal vein and the rest comes from the hepatic artery. PVT is a universal problem in LT. PVT was divided into grades I-IV by Yerdel et al. in 2000 [2]. For patients with grade I-III PVT, they could be managed through thrombectomy or reconstruction. The most severe grade IV PVT is defined as complete portal vein and entire SMV thrombosis [2–4]. For grade IV PVT, direct anastomosis of the donor’s portal vein to the recipient’s portal vein is not feasible even if vascular allograft is used.
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2022, Vol. 21 
