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Gastroenterology Research and Practice
Volume 2015, Article ID 810851, 6 pages
Clinical Study

Systemic Venous Inflow to the Liver Allograft to Overcome Diffuse Splanchnic Venous Thrombosis

1Department of Surgery, University of Medicine and Pharmacy “Gr.T.Popa”, University Hospital St. Spiridon, Iasi, Romania
2Starzl Unit of Abdominal Transplantation, Cliniques Universitaires St. Luc, Université Catholique de Louvain (UCL), 1200 Brussels, Belgium
3Department of Imaging, Unit of Interventional Radiology, Cliniques Universitaires St. Luc, Université Catholique de Louvain (UCL), 1200 Brussels, Belgium

Received 7 February 2015; Accepted 17 March 2015

Academic Editor: Hao Xu

Copyright © 2015 Cristian Lupascu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Diffuse splanchnic venous thrombosis (DSVT), formerly defined as contraindication for liver transplantation (LT), is a serious challenge to the liver transplant surgeon. Portal vein arterialisation, cavoportal hemitransposition and renoportal anastomosis, and finally combined liver and small bowel transplantation are all possible alternatives to deal with this condition. Five patients with preoperatively confirmed extensive splanchnic venous thrombosis were transplanted using cavoportal hemitransposition (4x) and renoportal anastomosis (1x). Median follow-up was 58 months (range: 0,5 to 130 months). Two patients with previous radiation-induced peritoneal injury died, respectively, 18 days and 2 months after transplantation. The three other patients had excellent long-term survival, despite the fact that two of them needed a surgical reintervention for severe gastrointestinal bleeding. Extensive splanchnic venous thrombosis is no longer an absolute contraindication to liver transplantation. Although cavoportal hemitransposition and renoportal anastomosis undoubtedly are life-saving procedures allowing for ensuring adequate allograft portal flow, careful follow-up of these patients remains necessary as both methods are unable to completely eliminate the complications of (segmental) portal hypertension.