Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Background: To evaluate the safety and efficacy of intraoperative endovascular treatment (EVT) using the donor ligamentum teres hepatis (LTH) approach for Yerdel grade III/IV portal vein thrombosis (PVT) during liver transplantation (LT), a condition that poses a major challenge in complex surgeries.
Methods: This single-center retrospective cohort study included some patients with grade III/IV PVT who underwent LT and were divided into two periods: in both periods, patients underwent modified eversion thrombectomy. However, in Period 1 (2016-2019), nonanatomical anastomosis was performed if portal flow was insufficient, and in Period 2 (2019-2024), patients with persistent hypoperfusion underwent additional LTH-based EVT (stenting or shunt occlusion). Perioperative outcomes (operative time, anhepatic phase, and anastomosis type) and long-term outcomes (graft survival and complication rates) were compared between groups.
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Period 1 |
| ||
| Period 2 |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| nonanatomical anastomosis | Procedure | In Period 1 (2016-2019, n=41), nonanatomical anastomosis was performed if portal flow was insufficient. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Operative Time | Operative time refers to the duration from the initial surgical incision to the completion of skin closure. | Intraoperative |
| Anhepatic Phase Time | The anhepatic phase time is the critical period during liver transplant surgery when the patient's native liver has been removed and the donor liver has not yet been reperfused. | Intraoperative |
| Rate of Nonanatomical Reconstruction | The rate of nonanatomical resection refers to the frequency with which a surgical procedure removes a tumor without following the boundaries of the organ's functional anatomical units. | Intraoperative |
| Delayed Graft Function | Delayed graft function is a common complication following kidney transplantation where the transplanted organ does not function immediately, often necessitating dialysis within the first week post-surgery. | Within 7 days postoperatively |
| Portal Vein Complications | Portal vein complications are a serious concern in liver transplantation, encompassing issues such as thrombosis, stenosis, and occlusion that can threaten graft survival and patient life. | From the surgery to the last follow-up (median follow-up 28 months) |
| Graft Survival | Graft survival refers to the continued functional existence of a transplanted organ or tissue within a recipient's body. | 1-year and 3-year postoperatively |
Not provided
Not provided
Inclusion Criteria:
Exclusion Criteria:
Not provided
Not provided
Not provided
Conducted a retrospective cohort analysis of 1,478 consecutive adult patients (aged ≥18 years) who underwent deceased-donor liver transplantation at Tianjin First Central Hospital between February 2016 and December 2024.From this population, the investigators identified 75 recipients with Yerdel grade III/IV PVT, which was confirmed by multiphase contrast-enhanced CT, indirect portography, and intraoperative evaluation. Exclusion criteria were living-donor and split-liver procedures. All procedures were performed using classic orthotopic transplantations. To evaluate the evolution of our PVT management strategy, the investigators divided the cohort into two chronologically distinct periods: period 1 (pre-intervention): February 2016-January 2019 (n=41), and period 2 (LTH protocol): February 2019-December 2024 (n=34).
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| LTH-based EVT | Procedure | In Period 2 (2019-2024, n=34), patients with persistent hypoperfusion underwent additional LTH-based EVT (stenting or shunt occlusion) |
|