Liver transplantation for cirrhosis complicated by non-tumor thrombosis of mesenteric portal system
S. E. Voskanyan,
A. I. Artemiev,
E. V. Naidenov,
K. K. Gubarev,
I. Yu. Kolyshev,
V. S. Rudakov,
D. A. Zabezhinsky,
A. N. Bashkov,
A. I. Sushkov,
M. V. Popov,
M. M. Fozilov,
D. S. Svetlakova,
A. P. Maltseva https://doi.org/10.16931/1995-5464.2022-4-71-83
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Abstract
Aim. To develop a universal technology of thrombectomy from the veins of the mesenteric portal system and to evaluate the outcomes of liver transplantation for cirrhosis combined with non-tumorous portal vein thrombosis.
Materials and methods. Immediate and long-term results of 309 transplantations in patients with liver cirrhosis of various etiologies were studied. In 46 cases (14.9%), transplantation was performed in patients with liver cirrhosis and concomitant thrombosis in the veins of the mesenteric portal system.
Results. A versatile method of thrombectomy, depending on the degree of thrombosis in the veins of the mesenteric portal system was proposed (M.A. Yerdel et al., 2000). Mesenteric portal vein thrombosis increased duration of transplantation and volume of intraoperative blood loss as compared to patients without concomitant thrombosis. No statistically significant differences were found in the overall incidence of postoperative complications, hospital mortality and duration of hospitalization of the patients after liver transplantation with concomitant venous thrombosis compared to the patients without thrombosis. The incidence of thrombotic complications, including hepatic artery thrombosis, was significantly higher after liver transplantation supplemented with thrombectomy from the portal vein system. Five-year survival rate of the patients after liver transplantation with concomitant thrombosis in the veins of the mesenteric portal system was 94.9% (median – 40 months), patients without thrombosis in the veins of the mesenteric portal system – 93.2% (median – 60 months).
Conclusion. Transplantation in patients with cirrhosis and thrombosis in the veins of the mesenteric-portal system shows good immediate and long-term results in case proper thrombectomy is carried out.
About the Authors
S. E. Voskanyan
Federal State Budgetary Institution “State Scientific Center of the Russian Federation – Federal Medical Biophysical Center named after A.I. Burnazyan” of the FMBA of Russia
Russian Federation
Russian Federation
Sergey E. Voskanyan – Doct. of Sci. (Med.), Professor, Corresponding Member of the Russian Academy of Sciences, Deputy Chief Physician for Surgical Care, Head of the Center for Surgery and Transplantation, Head of the Department of Surgery with courses in Oncosurgery, Endoscopy, Surgical Pathology, Clinical Transplantation and Organ Donation, Medico-Biological University of Innovations and Continuing Education (MBU INO)
23, Marshal Novikov str., Moscow, 123098
A. I. Artemiev
Federal State Budgetary Institution “State Scientific Center of the Russian Federation – Federal Medical Biophysical Center named after A.I. Burnazyan” of the FMBA of Russia
Russian Federation
Russian Federation
Alexey I. Artemiev – Cand. of Sci. (Med.), Head of Surgical Department №2, Center for Surgery and Transplantation
23, Marshal Novikov str., Moscow, 123098
E. V. Naidenov
Federal State Budgetary Institution “State Scientific Center of the Russian Federation – Federal Medical Biophysical Center named after A.I. Burnazyan” of the FMBA of Russia
Russian Federation
Russian Federation
Evgenii V. Naidenov – Cand. of Sci. (Med.), Operating Surgeon, Surgical Department №2, Center for Surgery and Transplantation
23, Marshal Novikov str., Moscow, 123098
Phone: +7-499-190-95-61
K. K. Gubarev
Federal State Budgetary Institution “State Scientific Center of the Russian Federation – Federal Medical Biophysical Center named after A.I. Burnazyan” of the FMBA of Russia
Russian Federation
Russian Federation
Konstantin K. Gubarev – Cand. of Sci. (Med.), Head of Surgical Department, Coordination Center for Human Organ and/or Tissue Donation
23, Marshal Novikov str., Moscow, 123098
I. Yu. Kolyshev
Federal State Budgetary Institution “State Scientific Center of the Russian Federation – Federal Medical Biophysical Center named after A.I. Burnazyan” of the FMBA of Russia
Russian Federation
Russian Federation
Ilya Yu. Kolyshev – Cand. of Sci. (Med.), Head of the Center for New Surgical Technologies
23, Marshal Novikov str., Moscow, 123098
V. S. Rudakov
Federal State Budgetary Institution “State Scientific Center of the Russian Federation – Federal Medical Biophysical Center named after A.I. Burnazyan” of the FMBA of Russia
Russian Federation
Russian Federation
Vladimir S. Rudakov – Cand. of Sci. (Med.), Operating Surgeon, Coordination Center for Human Organ and/or Tissue Donation, Center for Surgery and Transplantation
23, Marshal Novikov str., Moscow, 123098
D. A. Zabezhinsky
Federal State Budgetary Institution “State Scientific Center of the Russian Federation – Federal Medical Biophysical Center named after A.I. Burnazyan” of the FMBA of Russia
Russian Federation
Russian Federation
Dmitry A. Zabezhinsky – Cand. of Sci. (Med.), Operating Surgeon, Surgical Department №2, Center for Surgery and Transplantation
23, Marshal Novikov str., Moscow, 123098
A. N. Bashkov
Federal State Budgetary Institution “State Scientific Center of the Russian Federation – Federal Medical Biophysical Center named after A.I. Burnazyan” of the FMBA of Russia
Russian Federation
Russian Federation
Andrey N. Bashkov – Cand. of Sci. (Med.), Head of Department of Radiation and Radioisotope Diagnostics
23, Marshal Novikov str., Moscow, 123098
A. I. Sushkov
Federal State Budgetary Institution “State Scientific Center of the Russian Federation – Federal Medical Biophysical Center named after A.I. Burnazyan” of the FMBA of Russia
Russian Federation
Russian Federation
Alexandr I. Sushkov – Cand. of Sci. (Med.), Head of Laboratory №50
23, Marshal Novikov str., Moscow, 123098
M. V. Popov
Federal State Budgetary Institution “State Scientific Center of the Russian Federation – Federal Medical Biophysical Center named after A.I. Burnazyan” of the FMBA of Russia
Russian Federation
Russian Federation
Maxim V. Popov – Cand. of Sci. (Med.), Doctor in X-ray Endovascular Diagnostics and Treatment, Department of X-ray Surgical Methods of Diagnosis and Treatment
23, Marshal Novikov str., Moscow, 123098
M. M. Fozilov
Federal State Budgetary Institution “State Scientific Center of the Russian Federation – Federal Medical Biophysical Center named after A.I. Burnazyan” of the FMBA of Russia
Russian Federation
Russian Federation
Mamurjon M. Fozilov – PhD Student, Department of Surgery with courses in Oncosurgery, Endoscopy, Surgical Pathology, Clinical Transplantation and Organ Donation
23, Marshal Novikov str., Moscow, 123098
D. S. Svetlakova
Federal State Budgetary Institution “State Scientific Center of the Russian Federation – Federal Medical Biophysical Center named after A.I. Burnazyan” of the FMBA of Russia
Russian Federation
Russian Federation
Daria S. Svetlakova – Operating Surgeon, Coordination Center for Human Organ and/or Tissue Donation, Center for Surgery and Transplantation
23, Marshal Novikov str., Moscow, 123098
A. P. Maltseva
Federal State Budgetary Institution “State Scientific Center of the Russian Federation – Federal Medical Biophysical Center named after A.I. Burnazyan” of the FMBA of Russia
Russian Federation
Russian Federation
Anna P. Maltseva – Surgeon, Surgical Department №1, Center for New Surgical Technologies
23, Marshal Novikov str., Moscow, 123098
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Voskanyan S.E., Artemiev A.I., Naidenov E.V., Gubarev K.K., Kolyshev I.Yu., Rudakov V.S., Zabezhinsky D.A., Bashkov A.N., Sushkov A.I., Popov M.V., Fozilov M.M., Svetlakova D.S., Maltseva A.P. Liver transplantation for cirrhosis complicated by non-tumor thrombosis of mesenteric portal system. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2022;27(4):71-83. (In Russ.) https://doi.org/10.16931/1995-5464.2022-4-71-83
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ISSN 1995-5464 (Print)
ISSN 2408-9524 (Online)
ISSN 2408-9524 (Online)
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