Stieber et al used a classification to describe portal vein thrombosis in a patient undergoing a liver transplant. The extent of disease has implications for the transplant procedure. The authors are from the University of Pittsburgh.
Patient selection: liver transplant recipient
Main Portal Vein
Other Vein(s)
Type
thrombus
none
A
superior mesenteric
B
proximal splenic
C
extensive (superior mesenteric, splenic, inferior mesenteric)
D
where:
• Thrombosis in the intrahepatic, left or right portal veins is not included in the diagram.
The authors used the extent of portal vein thrombosis in a management algorithm (Figure 16):
Extent on Portogram
Management Strategy
partial thrombosis of portal vein or recanalized portal vein
direct dissection and anastomosis
complete thrombosis of portal vein with or without splenic vein thrombosis
jump graft
extensive thrombosis
declotting, anticoagulation
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Specialty: Gastroenterology, Surgery, general