Influence of Cirrhotic Portal Hypertension and Its Complications on Liver Transplantation_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YE Sheng , DONG Jiahong

Institute of Hepatobiliary Surgery, China PLA General Hospital, Beijing 100853, China;

Corresponding author：

Keywords：

Liver transplantation; Hepatic cirrhosis; Portal hypertension; Complications

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Objective 　To explore the influence of cirrhotic portal hypertension and its complications on liver transplantation.
Methods 　The literatures of the recent years on influence of hepatic cirrhotic portal hypertension on liver transplantation were reviewed.
Results 　Splenomegaly, hypersplenism, portal vein thrombosis, portosystemic shunt and collateral flow in cirrhotic patients will increase the difficulty of liver transplantation and lead to more postoperative complications. Appropriate handling of these conditions can achieve a higher success rate of liver transplantation.
Conclusion 　Correct management of end-stage cirrhotic portal hypertension and its complications can expand the indications of liver transplantation and improve long-term survival rates.

Citation： YE Sheng,DONG Jiahong. Influence of Cirrhotic Portal Hypertension and Its Complications on Liver Transplantation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2007, 14(3): 364-367. doi: Copy

1.	Lo CM, Fan ST, Chan JK, et al. Minimum graft volume for successful adult-to-adult living donor liver transplantation for fulminant hepatic failure [J]. Transplantation， 1996; 62(5)∶696.
2.	Ben-Haim M, Emre S, Fishbein TM, et al. Critical graft size in adult-to-adult living donor liver transplantation: impact of the recipient’s disease [J]. Liver Transpl， 2001; 7(11)∶948.
3.	Geissler I, Lamesch P, Witzigmann H, et al. Splenohepatic arterial steal syndrome in liver transplantation: clinical features and management [J]. Transpl Int， 2002; 15(2-3)∶139.
4.	Pozzato C, Marzano L, Botta A, et al. Splenomegaly and hypersplenism in cirrhotic patients before and after orthotopic liver transplantation [J]. Radiol Med (Torino)， 1998; 95(4)∶349.
5.	Egami S, Sugawara Y, Mizuta K, et al. Effect of pediatric living-donor liver transplantation on splenomegaly [J]. Transplantation， 2002; 74(11)∶1639.
6.	Neumann UP, Langrehr JM, Kaisers U, et al. Simultaneous splenectomy increases risk for opportunistic pneumonia in patients after liver transplantation [J]. Transpl Int， 2002; 15(5)∶226.
7.	Cescon M, Sugawara Y, Takayama T, et al. Role of splenectomy in living-donor liver transplantation for adults [J]. Hepatogastroenterology， 2002; 49(45)∶721.
8.	Sockrider CS, Boykin KN, Green J, et al. Partial splenic embolization for hypersplenism before and after liver transplantation [J]. Clin Transplant， 2002; 16 Suppl 7∶59.
9.	Sockrider CS, Boykin KN, Green J, et al. Partial splenic embolization for hypersplenism after liver transplantation [J]. Transplant Proc， 2001; 33(7-8)∶3472.
10.	Ou HY, Huang TL, Chen TY, et al. Emergency splenic arterial embolization for massive variceal bleeding in liver recipient with left-sided portal hypertension [J]. Liver Transpl， 2005; 11(9)∶1136.
11.	Firat A, Boyvat F, Moray G, et al. Comparison of two different percutaneous splenic artery interventions in the treatment of hypersplenism: preliminary report [J]. Transplant Proc， 2005; 37(2)∶1094.
12.	Dell’Era A, Grande L, Barros-Schelotto P, et al. Impact of prior portosystemic shunt procedures on outcome of liver transplantation [J]. Surgery， 2005; 137(6)∶620.
13.	Spencer LT, Langham MR, Hoyer MH, et al. Resolution of hypoxemia in a liver transplant recipient after ligation of a portosystemic shunt [J]. J Pediatr， 2000; 137(4)∶575.
14.	Sekido H, Matsuo K, Takeda K, et al. Severe fatty change of the graft liver caused by a portosystemic shunt of mesenteric varices [J]. Transpl Int， 2002; 15(5)∶259.
15.	Malassagne B, Soubrane O, Dousset B, et al. Extrahepatic portal hypertension following liver transplantation: a rare but challenging problem [J]. HPB Surg， 1998; 10(6)∶357.
16.	Troisi R, Ricciardi S, Smeets P, et al. Effects of hemi-portocaval shunts for inflow modulation on the outcome of small-for-size grafts in living donor liver transplantation [J]. Am J Transplant， 2005; 5(6)∶1397.
17.	Sato Y, Yamamoto S, Takeishi T, et al. Management of major portosystemic shunting in small-for-size adult living-related donor liver transplantation with a left-sided graft liver [J]. Surg Today， 2006; 36(4)∶354.
18.	Kato T, Levi DM, DeFaria W, et al. Liver transplantation with renoportal anastomosis after distal splenorenal shunt [J]. Arch Surg， 2000; 135(12)∶1401.
19.	Yerdel MA, Gunson B, Mirza D, et al. Portal vein thrombosis in adults undergoing liver transplantation: risk factors, screening, management, and outcome [J]. Transplantation， 2000; 69(9)∶1873.
20.	Molmenti EP, Roodhouse TW, Molmenti H, et al. Thrombendvenectomy for organized portal vein thrombosis at the time of liver transplantation [J]. Ann Surg， 2002; 235(2)∶292.
21.	Robles R, Fernandez JA, Hernandez Q, et al. Eversion thromboendovenectomy for organized portal vein thrombosis encountered during liver transplantation [J]. Transplant Proc， 2003; 35(5)∶1915.
22.	Azoulay D, Adam R, Castaing D, et al.Liver transplantation with cavoportal or renoportal anastomosis: a solution in cases of diffuse portal thrombosis [J]. Gastroenterol Clin Biol， 2002; 26(4)∶325.
23.	Gerunda GE, Merenda R, Neri D, et al. Cavoportal hemitransposition: a successful way to overcome the problem of total portosplenomesenteric thrombosis in liver transplantation [J]. Liver Transpl， 2002; 8(1)∶72.
24.	Charco R, Margarit C, Lopez-Talavera JC, et al.Outcome and hepatic hemodynamics in liver transplant patients with portal vein arterialization [J]. Am J Transplant， 2001; 1(2)∶146.
25.	Ott R, Bohner C, Muller S, et al. Outcome of patients with pre-existing portal vein thrombosis undergoing arterialization of the portal vein during liver transplantation [J]. Transpl Int， 2003; 16(1)∶15.
26.	Vianna R, Giovanardi RO, Fridell JA, et al. Multivisceral transplantation for diffuse portomesenteric thrombosis in a patient with life-threatening esophagogastroduodenal bleeding [J]. Transplantation， 2005; 80(4)∶534.
27.	Senzolo M, Patch D, Cholongitas E, et al. Severe venoocclusive disease after liver transplantation treated with transjugular intrahepatic portosystemic shunt [J]. Transplantation， 2006; 82(1)∶132.

1. Lo CM, Fan ST, Chan JK, et al. Minimum graft volume for successful adult-to-adult living donor liver transplantation for fulminant hepatic failure [J]. Transplantation， 1996; 62(5)∶696.
2. Ben-Haim M, Emre S, Fishbein TM, et al. Critical graft size in adult-to-adult living donor liver transplantation: impact of the recipient’s disease [J]. Liver Transpl， 2001; 7(11)∶948.
3. Geissler I, Lamesch P, Witzigmann H, et al. Splenohepatic arterial steal syndrome in liver transplantation: clinical features and management [J]. Transpl Int， 2002; 15(2-3)∶139.
4. Pozzato C, Marzano L, Botta A, et al. Splenomegaly and hypersplenism in cirrhotic patients before and after orthotopic liver transplantation [J]. Radiol Med (Torino)， 1998; 95(4)∶349.
5. Egami S, Sugawara Y, Mizuta K, et al. Effect of pediatric living-donor liver transplantation on splenomegaly [J]. Transplantation， 2002; 74(11)∶1639.
6. Neumann UP, Langrehr JM, Kaisers U, et al. Simultaneous splenectomy increases risk for opportunistic pneumonia in patients after liver transplantation [J]. Transpl Int， 2002; 15(5)∶226.
7. Cescon M, Sugawara Y, Takayama T, et al. Role of splenectomy in living-donor liver transplantation for adults [J]. Hepatogastroenterology， 2002; 49(45)∶721.
8. Sockrider CS, Boykin KN, Green J, et al. Partial splenic embolization for hypersplenism before and after liver transplantation [J]. Clin Transplant， 2002; 16 Suppl 7∶59.
9. Sockrider CS, Boykin KN, Green J, et al. Partial splenic embolization for hypersplenism after liver transplantation [J]. Transplant Proc， 2001; 33(7-8)∶3472.
10. Ou HY, Huang TL, Chen TY, et al. Emergency splenic arterial embolization for massive variceal bleeding in liver recipient with left-sided portal hypertension [J]. Liver Transpl， 2005; 11(9)∶1136.
11. Firat A, Boyvat F, Moray G, et al. Comparison of two different percutaneous splenic artery interventions in the treatment of hypersplenism: preliminary report [J]. Transplant Proc， 2005; 37(2)∶1094.
12. Dell’Era A, Grande L, Barros-Schelotto P, et al. Impact of prior portosystemic shunt procedures on outcome of liver transplantation [J]. Surgery， 2005; 137(6)∶620.
13. Spencer LT, Langham MR, Hoyer MH, et al. Resolution of hypoxemia in a liver transplant recipient after ligation of a portosystemic shunt [J]. J Pediatr， 2000; 137(4)∶575.
14. Sekido H, Matsuo K, Takeda K, et al. Severe fatty change of the graft liver caused by a portosystemic shunt of mesenteric varices [J]. Transpl Int， 2002; 15(5)∶259.
15. Malassagne B, Soubrane O, Dousset B, et al. Extrahepatic portal hypertension following liver transplantation: a rare but challenging problem [J]. HPB Surg， 1998; 10(6)∶357.
16. Troisi R, Ricciardi S, Smeets P, et al. Effects of hemi-portocaval shunts for inflow modulation on the outcome of small-for-size grafts in living donor liver transplantation [J]. Am J Transplant， 2005; 5(6)∶1397.
17. Sato Y, Yamamoto S, Takeishi T, et al. Management of major portosystemic shunting in small-for-size adult living-related donor liver transplantation with a left-sided graft liver [J]. Surg Today， 2006; 36(4)∶354.
18. Kato T, Levi DM, DeFaria W, et al. Liver transplantation with renoportal anastomosis after distal splenorenal shunt [J]. Arch Surg， 2000; 135(12)∶1401.
19. Yerdel MA, Gunson B, Mirza D, et al. Portal vein thrombosis in adults undergoing liver transplantation: risk factors, screening, management, and outcome [J]. Transplantation， 2000; 69(9)∶1873.
20. Molmenti EP, Roodhouse TW, Molmenti H, et al. Thrombendvenectomy for organized portal vein thrombosis at the time of liver transplantation [J]. Ann Surg， 2002; 235(2)∶292.
21. Robles R, Fernandez JA, Hernandez Q, et al. Eversion thromboendovenectomy for organized portal vein thrombosis encountered during liver transplantation [J]. Transplant Proc， 2003; 35(5)∶1915.
22. Azoulay D, Adam R, Castaing D, et al.Liver transplantation with cavoportal or renoportal anastomosis: a solution in cases of diffuse portal thrombosis [J]. Gastroenterol Clin Biol， 2002; 26(4)∶325.
23. Gerunda GE, Merenda R, Neri D, et al. Cavoportal hemitransposition: a successful way to overcome the problem of total portosplenomesenteric thrombosis in liver transplantation [J]. Liver Transpl， 2002; 8(1)∶72.
24. Charco R, Margarit C, Lopez-Talavera JC, et al.Outcome and hepatic hemodynamics in liver transplant patients with portal vein arterialization [J]. Am J Transplant， 2001; 1(2)∶146.
25. Ott R, Bohner C, Muller S, et al. Outcome of patients with pre-existing portal vein thrombosis undergoing arterialization of the portal vein during liver transplantation [J]. Transpl Int， 2003; 16(1)∶15.
26. Vianna R, Giovanardi RO, Fridell JA, et al. Multivisceral transplantation for diffuse portomesenteric thrombosis in a patient with life-threatening esophagogastroduodenal bleeding [J]. Transplantation， 2005; 80(4)∶534.
27. Senzolo M, Patch D, Cholongitas E, et al. Severe venoocclusive disease after liver transplantation treated with transjugular intrahepatic portosystemic shunt [J]. Transplantation， 2006; 82(1)∶132.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Influence of Cirrhotic Portal Hypertension and Its Complications on Liver Transplantation

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