Endovascular Recanalization of a Thrombosed Portocaval Hemitransposition Graft in a Liver Transplant Recipient

Abstract

Portal vein thrombosis was historically considered a contraindication for liver transplantation. However, recent technical advancements have enabled surgeons to manage this complication through various innovative approaches. One such technique is portocaval hemitransposition, particularly applicable in cases of extensive porto-splanchnic thrombosis. This procedure involves utilizing the recipient's inferior vena cava to perfuse the portal vein of the liver graft. We report a case of acute thrombosis of a portocaval hemitransposition graft that was successfully managed with catheter-directed thrombolysis, angioplasty, and stent placement.

Keywords

portocaval hemitransposition - portal vein thrombosis - liver transplantation

Publikationsverlauf

Artikel online veröffentlicht:
29. Juli 2025

• References

• 1 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 (02) 454-460
• 2 Olausson M, Norrby J, Mjornstedt L, Liden H, Friman S. Liver transplantation using cavoportal hemitransposition—a life-saving procedure in the presence of extensive portal vein thrombosis. Transplant Proc 2001; 33: 1329-1330
• 3 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 (01) 72-75
• 4 Haider HH, Froud T, Moon J. et al. Successful percutaneous pulse spray thrombolysis of extensive acute portocaval hemitransposition thrombosis. Transpl Int 2006; 19 (11) 941-944