Liver transplantation in the setting of a spontaneous shunt between superior mesenteric vein and right renal vein.
Liver transplantation in the setting of a spontaneous shunt between superior mesenteric vein and right renal vein. Ann Hepatol. 2019 Sep 11;: Authors: Chedid MF, Zahler S, Chedid AD, Leipnitz I, Prediger JE, Giampaoli AZD, Lopes BB, Kruel CRP, Grezzana-Filho TJM Abstract Shunts between the superior mesenteric vein (SMV) and the right renal vein (RRV) are very rare. Here, we describe and depict the rare case of a liver transplant (LT) in the setting of shunt between SMV and RRV. A 67-year-old white man presenting with Child C cirrhosis secondary to hemochromatosis and persistent encephalopathy was listed for LT. Preoperative abdominal angiotomography revealed the presence of a large spontaneous shunt between the SMV and the RRV. The patient underwent LT by receiving a liver from a 17-year-old brain-dead deceased donor victim of trauma. A large shunt between the SMV and the RRV was confirmed intraoperatively. Although there was no portal vein (PV) thrombosis, the PV was atrophic and had a reduced flow. PV pressure was 22mmHg (an arterial line was inserted inside the PV stump, and this line was connected to a common pressure transducer, the pressure readings was expressed in the anesthesia monitor). After shunt ligation PV pressure increased to 32mmHg. There were no post-transplant vascular complications, and the patient was discharged home in good health. Preoperative study of all LT candidates with angio CT scan is mandatory. Whenever there is PV thrombosi...
CONCLUSIONS: In this Chilean cohort, half of mesenteric or portal venous thrombosis showed no secondary cause. In this group, the main causes were MPN and hereditary thrombophilia. Nearly, all MPN patients had JAK2V617F mutation, but there was a group of patients having JAK2V617F mutation but did not meet MPN criteria. PMID: 32154655 [PubMed - as supplied by publisher]
PMID: 32112536 [PubMed - as supplied by publisher]
PMID: 32112529 [PubMed - as supplied by publisher]
Reply to "Comment on 'Comparison of three transfusion protocols prior to central venous catheterization in patients with cirrhosis; a randomized controlled trial'". J Thromb Haemost. 2020 Mar;18(3):754-755 Authors: Rocha LL, Corrêa TD PMID: 32112528 [PubMed - as supplied by publisher]
Portal vein thrombosis (PVT) is a common and serious complication in patients with cirrhosis. However, little is known about PVT in patients with cirrhosis and acute decompensation (AD). We investigated the prevalence and clinical significance of PVT in nonmalignant patients with cirrhosis and AD.
To determine the efficacy and safety of transjugular intrahepatic portosystemic shunt and portal vein recanalization (TIPS-PVR) for portal vein thrombosis (PVT) in patients without cirrhosis.
ConclusionsNSBBs may play a role in the progression of PVT in liver cirrhosis. The benefits and risks of NSBBs in the management of liver cirrhosis should be fully weighed.
This study aims to evaluate radiation exposure in patients with complete portal vein thrombosis (CPVT) or portal cavernoma (PC) undergoing transjugular intrahepatic portosystemic shunt (TIPS) creation using real-time ultrasound guidance for portal vein targeting.Materials and methodsThis is a single institution retrospective analysis. Between August 2009 and September 2018, TIPS was attempted in 49 patients with CPVT or PC. Radiation exposure (dose area product [DAP], air KERMA (AK) and fluoroscopy time [FT]), technical success, clinical success, complications and survival were analyzed.ResultsIn total, 29 patients had CPV...
No abstract available
Conclusions: HBV infection and replication status are associated with the formation of PVTT or extrahepatic metastasis in patients with HCC.