Transplantation proceedings · 2026
Portomesenteric Jump Graft for Liver Transplantation. Single Center Experience in Latin America.
СтатьяНазвание и аннотация: Перевод в очереди
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Reyes Natalia, Riveros Sergio, Irarrazaval María J, Ochoa Gabriela, Jarufe Nicolás, Viñuela Eduardo, Martínez Jorge, Dib Martin, Briceño Eduardo
Аннотация
INTRODUCTION: Chronic portal vein thrombosis and cavernomatosis are a complex challenge for liver transplantation. This study aims to analyze the results of portomesenteric reconstruction with a jump graft using the cadaveric iliac vein in liver transplantation.
MATERIAL AND METHODS: Non-concurrent cohort study from 2001 to 2023. All patients who underwent portal vein reconstruction with a mesenteric jump graft for liver transplantation were included.
RESULTS: Nineteen patients were included. Pretransplant diagnosis of portal vein thrombosis was in 13 patients (68,4%), with 7 of them (36.8%) receiving anticoagulation. A preoperative decision to perform the venous jump graft was made in 8 patients (42.1%). Intraoperatively, 11 patients were classified as grade III according to the Yerdel classification, and eight were found to have cavernomatosis. Eleven patients (57.9%) experienced major complications, with 7 patients requiring reoperation. None of the complications were related to the portomesenteric jump graft. Two patients (10,5%) died in the first 30 days. The 5-year overall and graft survival rates were identical at 63.2%, as no retransplantations occurred. The median follow-up for venous bridge patency was 18 months, identifying only 2 thrombosed bridges (13.3%).
CONCLUSIONS: Portomesenteric reconstruction with a jump graft using a cadaveric iliac vein yields favorable outcomes in this cohort of liver transplantations. This technique represents a vital surgical strategy, enabling transplantation for patients who would otherwise not be considered transplant candidates.
MATERIAL AND METHODS: Non-concurrent cohort study from 2001 to 2023. All patients who underwent portal vein reconstruction with a mesenteric jump graft for liver transplantation were included.
RESULTS: Nineteen patients were included. Pretransplant diagnosis of portal vein thrombosis was in 13 patients (68,4%), with 7 of them (36.8%) receiving anticoagulation. A preoperative decision to perform the venous jump graft was made in 8 patients (42.1%). Intraoperatively, 11 patients were classified as grade III according to the Yerdel classification, and eight were found to have cavernomatosis. Eleven patients (57.9%) experienced major complications, with 7 patients requiring reoperation. None of the complications were related to the portomesenteric jump graft. Two patients (10,5%) died in the first 30 days. The 5-year overall and graft survival rates were identical at 63.2%, as no retransplantations occurred. The median follow-up for venous bridge patency was 18 months, identifying only 2 thrombosed bridges (13.3%).
CONCLUSIONS: Portomesenteric reconstruction with a jump graft using a cadaveric iliac vein yields favorable outcomes in this cohort of liver transplantations. This technique represents a vital surgical strategy, enabling transplantation for patients who would otherwise not be considered transplant candidates.