Renoportal anastomosis in liver transplantation and its impact on patient outcomes: a systematic literature review

Transpl Int. 2019 Feb;32(2):117-127. doi: 10.1111/tri.13368. Epub 2018 Nov 20.

Abstract

Portal vein thrombosis (PVT) is commonly encountered during liver transplantation (LT). Depending on the grade of thrombosis, varied management strategies are indicated. The aims of this study are to clarify the contemporary role of renoportal anastomosis (RPA) in patients with splanchnic vein thrombosis (SVT) undergoing LT and to systematically analyze all reported cases of RPA. A systematic literature search was performed according to Preferred Reporting Items for Systematic Reviews and Meta- Analyses statement guidelines. The study was limited to studies reported in English between January 1997 and May 2017. Only retrospective single center studies were included in the analysis. A total of 66 patients with SVT were reported to have undergone RPA during LT. Transient renal dysfunction was reported in 12 patients (18.1%), variceal hemorrhage in 2 patients (3%), early portal vein (PV) re-thrombosis in 2 patients (3%), chronic renal dysfunction in 2 patients (3%), and late PV re-thrombosis in 1 patient (1.5%). The overall patient and graft survival were each 80%. This analysis illustrates the decades-long evolution of a technique practiced across the field of transplantation. Postoperative complications and graft survival appear to be encouraging, even in the setting of SVT.

Keywords: liver transplant; long term outcome; portal vein thrombosis; renoportal anastomosis; short term outcome.

Publication types

  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Anastomosis, Surgical / adverse effects*
  • Anastomosis, Surgical / methods*
  • End Stage Liver Disease / complications
  • End Stage Liver Disease / mortality
  • End Stage Liver Disease / surgery*
  • Esophageal and Gastric Varices
  • Female
  • Graft Survival
  • Hemorrhage / complications
  • Humans
  • Kidney Failure, Chronic / complications
  • Liver Transplantation / methods*
  • Male
  • Middle Aged
  • Portal Vein / pathology*
  • Postoperative Complications
  • Retrospective Studies
  • Splanchnic Circulation
  • Thrombosis
  • Treatment Outcome
  • Varicose Veins / physiopathology
  • Vascular Surgical Procedures / methods
  • Venous Thrombosis / surgery*
  • Waiting Lists
  • Young Adult