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? 4 Drs Aubrey & Von

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I know I’m getting ahead of myself here, but Ken will need another liver. Do either of you think asking his doctors

about putting a stent in the portal vein the next time around is a good idea? This study is pretty encouraging. His platelets are still high and I don’t

think that will change much, so there might be a fairly good chance for another

clot.

Your thoughts? Barb in Texas

Intraoperative stent placement in the portal vein

during or after liver transplantation

Yong-Jae Kim, Gi-Young Ko, Hyun-Ki Yoon, Ji-Hoon Shin, Heung-Kyu Ko, Kyu-Bo

Sung

Department of Radiology and Research Institute of

Radiology, University of Ulsan College of Medicine,

Asan Medical Center, Seoul, Korea

Abstract

The purpose of this research was to evaluate the

intermediate effectiveness of intraoperative portal

vein stent placement for portal venous stenosis in liver transplantation. We attempted intraoperative

portal vein stent placement in 44 portal venous anastomotic

stenoses in 36 patients. All

patients underwent stent placement via either the inferior or superior

mesenteric vein. A total of 22 patients underwent

portal vein stent placement simultaneously with liver transplantation, and 14

patients underwent stent placement 1-25 days (mean 5.93 days) after liver

transplantation. Of the 22 patients, there was

portal vein occlusion in 3 patients and small portal vein (<6 mm) in 10

patients (2.5-5.7 mm; mean size 3.9 mm). Patient

follow-up included clinical and laboratory data collection, Doppler ultrasonography (US), and computed tomography (CT). Intraoperative portal vein

stent placement was technically successful in all of our study patients, even

in 6 patients with total occlusion of the portal vein. A

total of 10 study patients underwent thrombectomy

of the portal vein, 1 underwent patient portosystemic

shunt ligation, and 7 patients had both procedures

simultaneously. Portal venous patency

has been maintained for 0-56 months (mean 16 months) in 42 (95%) of the 44

stent placements. In conclusion, intraoperative

portal vein stent placement is an effective and long lasting treatment

modality for treat portal venous stenosis, especially in patients with portal

vein occlusion or small sized portal vein. Liver Transpl 13:1145-1152, 2007. ©

2007 AASLD.

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