Complications of Venous Reconstruction in Human Orthotopic Liver Transplantation

Authors:
  • ATAndreas G. Tzakis
    Andreas G. Tzakis
  • KBKlaus Bron
    Klaus Bron
  • RGRobert D. Gordon
    Robert D. Gordon
  • SIShunzaburo Iwatsuki
    Shunzaburo Iwatsuki
  • CECarlos O. Esquivel
    Carlos O. Esquivel
  • LMLeonard Makowka
    Leonard Makowka
  • STSatoru Todo
    Satoru Todo
  • TSThomas E. Starzl
    Thomas E. Starzl
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Abstract
In 313 consecutive recipients of 393 orthotopic liver grafts, there were 51 (16.3%) and nine (2.9%) patients who had pre-existing portal vein and inferior vena cava abnormalities, respectively. These abnormalities required adjustments in the transplant operation and were a source of morbidity and mortality. The incidence of thrombosis of the reconstructed portal vein was 1.8%. Only three (0.8%) vena caval thromboses were seen after 393 liver replacements. Venous stenoses or disruptions were rare. Six women with the Budd-Chiari syndrome had liver replacement. Although this disorder is a veno-occlusive disease, five of the recipients achieved prolonged survival, only one had recurrence of disease, and three are alive after 2-6 years.