medigraphic.com
Órgano Oficial de la Asociación Mexicana de Hepatología

2008, Number 3

<< Back Next >>

Ann Hepatol 2008; 7 (3)

Cavoportal hemitransposition for the simultaneous thrombosis of the caval and portal systems - a review of the literature

Borchert DH

Language: Spanish
References: 84
Page: 200-211
PDF size: 205.20 Kb.


Text Extraction

Portal venous thrombosis was originally considered to be a contraindication for liver transplantation. Currently, several methods exist to re-establish blood flow to the hepatic portal system. Cavoportal hemitransposition is a surgical procedure that can be used in liver transplantation when the portal venous system is thrombosed and portal flow cannot be re-established from the mesenteric venous system. In cavoportal hemitransposition the blood flow from the inferior vena cava of the recipient is directed to the portal vein of the donor liver to compensate for the lost portal venous supply. This can either be done by end-to-end or end-to-side anastomosis. Seventy-one cases of cavoportal hemitransposition have been reported worldwide. All patients reported had been in a critical and life-threatening condition, presenting with either end–stage–liver disease or acute hepatic failure combined with severe vascular pathology. Of the cases reported, 32 patients died for reasons non-related to the surgical procedure. Seven of the 71 patients had Budd-Chiari syndrome complicated by thrombosis of the portal–venous system. This means thrombosis in two different venous systems at the same time, the mesenteric and main venous system. To date this «two-system» venous thrombosis of both the caval and portal system has only been reviewed together with the possible medical, radiological and non-transplant treatment options. This article evaluates the available literature and reviews the evolution of the surgical procedure of cavoportal hemitransposition emphasising its role in combined thrombosis of the hepatic veins and portal venous systems.


REFERENCES

  1. Ludwig J, Hashimoto E, McGill DB, van Heerden JA. Classification of hepatic venous outflow obstruction: ambiguous terminology of the Budd-Chiari syndrome. Mayo Clin Proc 1990; 65(1): 51-5.

  2. European Network for the vascular disease of the liver. Guidelines for the management of patients with Budd-Chiari syndrome. www.mh-hannover.de/kliniken/gastro/vasc/guideline_BCS.pdf , 1-33. 2005.

  3. Feng LS, Peng QP, Li K, et al. Management of severe Budd-Chiari syndrome: report of 147 cases. Hepatobiliary Pancreat Dis Int 2004; 3(4): 522-5.

  4. Xu PQ, Ma XX, Ye XX et al. Surgical treatment of 1360 cases of Budd-Chiari syndrome: 20-year experience. Hepatobiliary Pancreat Dis Int 2004; 3(3): 391-4.

  5. Jamieson NV, Williams R, Calne RY. Liver transplantation for Budd-Chiari syndrome, 1976-1990. Ann Chir 1991; 45(4): 362-5.

  6. Orloff MJ, Daily PO, Orloff SL, et al. A 27-year experience with surgical treatment of Budd-Chiari syndrome. Ann Surg 2000; 232(3): 340-52.

  7. Ulrich F, Steinmuller T, Lang M, et al. Liver transplantation in patients with advanced Budd-Chiari syndrome. Transplant Proc 2002; 34(6): 2278.

  8. Menon KV, Shah V, Kamath PS. The Budd-Chiari syndrome. N Engl J Med 2004; 350(6): 578-85.

  9. Srinivasan P, Rela M, Prachalias A, et al. Liver transplantation for Budd-Chiari syndrome. Transplantation 2002; 73(6): 973-7.

  10. Cazals-Hatem D, Vilgrain V, Genin P, et al. Arterial and portal circulation and parenchymal changes in Budd-Chiari syndrome: a study in 17 explanted livers. Hepatology 2003; 37(3): 510-9.

  11. Tanaka M, Wanless IR. Pathology of the liver in Budd-Chiari syndrome: portal vein thrombosis and the histogenesis of veno-centric cirrhosis, veno-portal cirrhosis, and large regenerative nodules. Hepatology 1998; 27(2): 488-96.

  12. European Network for the vascular disease of the liver. Guidelines for the management of patients with portal vein thrombosis. www.mh-hannover.de/kliniken/gastro/vasc/guideline_PVT.pdf . 2005.

  13. Stieber AC, Zetti G, Todo S, et al. The spectrum of portal vein thrombosis in liver transplantation. Ann Surg 1991; 213(3): 199-206.

  14. Yerdel MA, Gunson B, Mirza D, et al. Portal vein thrombosis in adults undergoing liver transplantation: risk factors, screening, management, and outcome. Transplantation 2000; 69(9): 1873-81.

  15. Bertelli R, Nardo B, Montalti R, et al. Liver transplantation in recipients with portal vein thrombosis: experience of a single transplant center. Transplant Proc 2005; 37(2): 1119-21.

  16. Brancatelli G, Federle MP, Pealer K, Geller DA. Portal venous thrombosis or sclerosis in liver transplantation candidates: preoperative CT findings and correlation with surgical procedure. Radiology 2001; 220(2): 321-8.

  17. Lipshutz GS, Patel S, Hiatt JR, et al. Portocaval hemitransposition in pediatric liver transplant recipients: a single-center experience. Liver Transpl 2006; 12(7): 1097-103.

  18. Tzakis AG, Kirkegaard P, Pinna AD, et al. Liver transplantation with cavoportal hemitransposition in the presence of diffuse portal vein thrombosis. Transplantation 1998; 65(5): 619-24.

  19. Cohen J, Edelman RR, Chopra S. Portal vein thrombosis: a review. Am J Med 1992; 92(2): 173-82.

  20. Shaked A, Busuttil RW. Liver transplantation in patients with portal vein thrombosis and central portacaval shunts. Ann Surg 1991; 214(6): 696-702.

  21. Nonami T, Yokoyama I, Iwatsuki S, Starzl TE. The incidence of portal vein thrombosis at liver transplantation. Hepatology 1992; 16(5): 1195-8.

  22. Bhattacharyya M, Makharia G, Kannan M, et al. Inherited prothrombotic defects in Budd-Chiari syndrome and portal vein thrombosis: a study from North India. Am J Clin Pathol 2004; 121(6): 844-7.

  23. Mahmoud AE, Helmy AS, Billingham L, Elias E. Poor prognosis and limited therapeutic options in patients with Budd-Chiari syndrome and portal venous system thrombosis. Eur J Gastroenterol Hepatol 1997; 9 (5): 485-9.

  24. Murad SD, Valla DC, de Groen PC, et al. Pathogenesis and treatment of Budd-Chiari syndrome combined with portal vein thrombosis. Am J Gastroenterol 2006; 101(1): 83-90.

  25. Tang TJ, Batts KP, de Groen PC, et al. The prognostic value of histology in the assessment of patients with Budd-Chiari syndrome. J Hepatol 2001; 35(3): 338-43.

  26. Azoulay D, Hargreaves GM, Castaing D, Bismuth H. Caval inflow to the graft: a successful way to overcome diffuse portal system thrombosis in liver transplantation. J Am Coll Surg 2000; 190(4): 493-6.

  27. Bakthavatsalam R, Marsh CL, Perkins JD, et al. Rescue of acute portal vein thrombosis after liver transplantation using a cavoportal shunt at re-transplantation. Am J Transplant 2001; 1(3): 284-7.

  28. Bernardos A, Serrano J, Gomez MA, et al. Portal vein thrombosis: an emergency solution for blood flow in liver transplantation. Transpl Int 2003; 16(8): 500-1.

  29. Ceulemans B, Aerts R, Monbaliu D, et al. Liver Transplantation using cavoportal transposition: An effective treatment in patients with complete splanchnic venous thrombosis. Transplant Proc 2005; 37(2): 1112-4.

  30. Gerunda GE, Merenda R, Neri D, et al. Cavoportal hemitransposition: a successful way to overcome the problem of total portosplenomesenteric thrombosis in liver transplantation. Liver Transpl 2002; 8(1): 72-5.

  31. Ho MC, Hu RH, Lai HS, et al. Liver transplantation in a patient with diffuse portal venous system thrombosis. Transplant Proc 2000; 32(7): 2174-6.

  32. Kumar N, Atkison P, Fortier MV, et al. Cavoportal transposition for portal vein thrombosis in a pediatric living-related liver transplantation. Liver Transpl 2003; 9(8): 874-6.

  33. Li FG, Yan LN, Wang WT. Extensive thrombosis of the portal vein and vena cava after orthotopic liver transplantation with cavoportal hemitransposition: a case report. Transplant Proc 2008; 40(5): 1777-9.

  34. Llado L, Fabregat J, Castellote J, et al. Management of portal vein thrombosis in liver transplantation: influence on morbidity and mortality. Clin Transplant 2007; 21(6): 716-21.

  35. Olausson M, Norrby J, Mjornstedt L, et al. Liver transplantation using cavoportal hemitransposition - A life-saving procedure in the presence of extensive portal vein thrombosis. Transplant Proc 2001; 33(1-2): 1327-8.

  36. Ozden I, Suoglu OD, Aydogan A. et al. Successful living-donor liver transplantation and retransplantation with cavoportal hemitransposition: a case report. Exp Clin Transplant 2006; 4(2): 562-6.

  37. Pinna AD, Nery J, Kato T, et al. Liver transplant with portocaval hemitransposition: experience at the University of Miami. Transplant Proc 2001; 33(1-2): 1329-30.

  38. Santaniello W, Ceriello A, Defez M, et al. Liver transplant with cavoportal hemitransposition for portal and mesenteric thrombosis: case report. Transplant Proc 2001; 33(1-2): 1488-9.

  39. Selvaggi G, Weppler D, Nishida S, et al. Ten-year experience in porto-caval hemitransposition for liver transplantation in the presence of portal vein thrombosis. Am J Transplant 2007; 7(2): 454-60.

  40. Shrotri M, Sudhindran S, Gibbs P, et al. Case report of cavoportal hemitransposition for diffuse portal vein thrombosis in liver transplantation. Transplant Proc 2003; 35(1): 397-8.

  41. Urbani L, Cioni R, Catalano G, et al. Cavoportal hemitransposition: patient selection criteria and outcome. Transplant Proc 2002; 34(8): 3331-3.

  42. Varma CR, Mistry BM, Glockner JF, et al. Cavoportal hemitransposition in liver transplantation. Transplantation 2001; 72(5): 960-3.

  43. Verran D, Crawford M, Stormon M, Shun A. Liver retransplantation in an infant requiring cavoportal hemi transposition. Pediatr Transplant 2004; 8(4): 416-9.

  44. Vincent C, Pomier-Layrargues G, Dagenais M et, al. Cure of gastric antral vascular ectasia by liver transplantation despite persistent portal hypertension: a clue for pathogenesis. Liver Transpl 2002; 8(8): 717-20.

  45. Wang C, Zhang T, Song S, et al. Liver transplant with portocaval hemitransposition: blood supply with only hepatic artery is possible? Transplant Proc 2005; 37(5): 2163-5.

  46. Weeks SM, Alexander JR, Sandhu J, et al. Mechanic and pharmacologic treatment of a saddle embolus to the portal vein after liver transplantation and portacaval hemitransposition. AJR Am J Roentgenol 2000; 175(2): 537-9.

  47. Yan ML, Zeng Y, Li B, et al. Postoperative complications after liver transplantation with cavoportal hemitransposition. Hepatobiliary Pancreat Dis Int 2008; 7(3): 322-4.

  48. Paskonis M, Jurgaitis J, Mehrabi A, et al. Surgical strategies for liver transplantation in the case of portal vein thrombosis—current role of cavoportal hemitransposition and renoportal anastomosis. Clin Transplant 2006; 20(5): 551-62.

  49. Klupp J, Kohler S, Pascher A, Neuhaus P. Liver transplantation as ultimate tool to treat portal hypertension. Dig Dis 2005; 23(1): 65-71.

  50. Loinaz C, Gomez R, Jimenez C, et al. Liver transplantation in patients with portal thrombosis: results in 76 patients. Transplant Proc 2002; 34(1): 248-9.

  51. Wang ZF, Liu C. Liver retransplantation: indications and outcomes. Hepatobiliary Pancreat Dis Int 2004; 3(2):75-8.

  52. Sauvanet A, Panis Y, Valla D, et al. Budd-Chiari syndrome with extensive portal thrombosis: treatment with Senning’s procedure. Hepatogastroenterology 1994; 41(2): 174-6.

  53. Hannoun L, Huguet C, Delva E, et al. Results of portal shunts for intractable ascites in patients with cirrhosis. 57 cases. Chirurgie 1988; 114(6): 497-501.

  54. Huguet C, Hannoun L, Nordlinger B, et al. Selective distal spleno-renal shunt. A report of 14 patients (author’s transl). Nouv Presse Med 1979; 8(47): 3881-4.

  55. Watanabe H, Shinzawa H, Saito T, et al. Successful emergency treatment with a transjugular intrahepatic portosystemic shunt for life-threatening Budd-Chiari syndrome with portal thrombotic obstruction. Hepatogastroenterology 2000; 47(33): 839-41.

  56. Stange B, Glanemann M, Nussler NC, et al. Indication, technique, and outcome of portal vein arterialization in orthotopic liver transplantation. Transplant Proc 2001; 33(1-2): 1414-5.

  57. Azoulay D, Adam R, Castaing D, et al. Liver transplantation with cavoportal or renoportal anastomosis: a solution in cases of diffuse portal thrombosis. Gastroenterol Clin Biol 2002; 26(4): 325-30.

  58. Eck NV. K voprosu o perevyazkie vorotnois veni: Predvaritelnoye soobschjenye. Voen Med J 1877; 130: 1-2.

  59. Starzl TE, Porter KA, Francavilla A. The Eck fistula in animals and humans. Curr Probl Surg 1983; 20(11): 687-752.

  60. Hahn M, Massen O, Nencki M, Pawlow J. Die Eck´sche Fistel zwischen der unteren Hohlvene und der Pfortader und ihre Folgen für den Organismus. Arch Exp Pathol Pharmakol 1893; 32: 161-210.

  61. Child CGI, Barr D, Holswade GR, Harrison CS. Liver regeneration following portacaval transposition in dogs. Ann Surg 1953; 138(4): 600-8.

  62. Riddell AG, Davies RP, Clark AD. Portacaval transposition in the treatment of glycogen-storage disease. Lancet 1966; 2(7474): 1146-8.

  63. Meyer WH, Jr., Starzl TE. The reverse portacaval shunt. Surgery 1959; 45: 660-.

  64. Silen W, Mawdsley DL, Weirich WL, Harper HA. Studies of hepatic function in dogs with Eck fistula or portacaval transposition. AMA Arch Surg 1957; 74(6): 964-70.

  65. Starzl TE, Putnam CW, Porter KA, et al. Portal diversion for the treatment of glycogen storage disease in humans. Ann Surg 1973; 178(4): 525-39.

  66. Jamieson NV. Changing perspectives in portal vein thrombosis and liver transplantation. Transplantation 2000; 69(9): 1772-4.

  67. Eguchi S, Yanaga K, Sugiyama N, et al. Relationship between portal venous flow and liver regeneration in patients after living donor right-lobe liver transplantation. Liver Transpl 2003; 9(6): 547-51.

  68. Garcia-Valdecasas JC, Fuster J, Charco R, et al. Changes in portal vein flow after adult living-donor liver transplantation: does it influence postoperative liver function? Liver Transpl 2003; 9(6): 564-9.

  69. Lo CM, Liu CL, Fan ST. Portal hyperperfusion injury as the cause of primary nonfunction in a small-for-size liver graft-successful treatment with splenic artery ligation. Liver Transpl 2003; 9(6): 626-8.

  70. Sugimoto H, Kaneko T, Hirota M, et al. Critical progressive small-graft injury caused by intrasinusoidal pressure elevation following living donor liver transplantation. Transplant Proc 2004; 36(9): 2750-6.

  71. Henderson JM, Gilmore GT, Mackay GJ, et al. Hemodynamics during liver transplantation: the interactions between cardiac output and portal venous and hepatic arterial flows. Hepatology 1992; 16(3): 715-8.

  72. Paulsen AW, Klintmalm GB. Direct measurement of hepatic blood flow in native and transplanted organs, with accompanying systemic hemodynamics. Hepatology 1992; 16(1): 100-11.

  73. Starzl TE, Putnam CW, Porter KA, Benichou J. Portacaval shunt for glycogen storage disease and hyperlipidaemia. Ciba Found Symp 1977; (55): 311-25.

  74. Dahan H, Arrive L, Monnier-Cholley L, et al. Cavoportal collateral pathways in vena cava obstruction: imaging features. AJR Am J Roentgenol 1998; 171(5): 1405-11.

  75. Abrams HL. The vertebral and azygos venous systems, and some variations in systemic venous return. Radiology 1957; 69(4): 508-26.

  76. Monkhouse WS, Khalique A. The adrenal and renal veins of man and their connections with azygos and lumbar veins. J Anat 1986; 146: 105-15.

  77. Seib GA. Azygos System of Veins in American White and American Negroes, Including Observations on Inferior Caval Venous System. Am J Phys Anthropol 1934; 19: 39-163.

  78. Settmacher U, Nussler NC, Glanemann M, et al. Venous complications after orthotopic liver transplantation. Clin Transplant 2000; 14(3): 235-41.

  79. Novel procedure: percutaneous, via TIPS, portal vein thrombectomy in patients with Budd-Chiari syndrome complicated by acute portal vein thrombosis. Tel-Aviv, Israel.: 2005.

  80. Leebeek FW, Lameris JS, van Buuren HR, et al. Budd-Chiari syndrome, portal vein and mesenteric vein thrombosis in a patient homozygous for factor V Leiden mutation treated by TIPS and thrombolysis. Br J Haematol 1998; 102(4): 929-31.

  81. Mancuso A, Watkinson A, Tibballs J, et al. Budd-Chiari syndrome with portal, splenic, and superior mesenteric vein thrombosis treated with TIPS: who dares wins. Gut 2003; 52(3): 438.

  82. Opitz T, Buchwald AB, Lorf T, et al. The transjugular intrahepatic portosystemic stent-shunt (TIPS) as rescue therapy for complete Budd-Chiari syndrome and portal vein thrombosis. Z Gastroenterol 2003; 41(5): 413-8.

  83. Pfammatter T, Benoit C, Cathomas G, Blum U. Budd-Chiari syndrome with spleno-mesenteric-portal thrombosis: treatment with extended TIPS. J Vasc Interv Radiol 2000; 11(6): 781-4.

  84. Haider HH, Froud T, Moon J, et al. Successful percutaneous pulse spray thrombolysis of extensive acute portocaval hemitransposition thrombosis. Transpl Int 2006; 19(11): 941-4.




2020     |     www.medigraphic.com