Novel classification of non-malignant portal vein thrombosis: A guide to surgical decision-making during liver transplantation
Non-tumoral portal vein thrombosis (PVT) is present at liver transplantation in 5% to 26% of cirrhotic patients, and the prevalence of complex PVT as defined here (grade 4 Yerdel, and grade 3,4 Jamieson and Charco) has been reported in 0% to 2.2%. Adequate portal inflow is mandatory to ensure graft...
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| Veröffentlicht in: | Journal of hepatology 2019-11, Vol.71 (5), p.1038-1050 |
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| container_title | Journal of hepatology |
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| creator | Bhangui, Prashant Lim, Chetana Levesque, Eric Salloum, Chady Lahat, Eylon Feray, Cyrille Azoulay, Daniel |
| description | Non-tumoral portal vein thrombosis (PVT) is present at liver transplantation in 5% to 26% of cirrhotic patients, and the prevalence of complex PVT as defined here (grade 4 Yerdel, and grade 3,4 Jamieson and Charco) has been reported in 0% to 2.2%. Adequate portal inflow is mandatory to ensure graft and patient survival after liver transplantation. With time, the proposed classifications of non-tumoral chronic PVT have evolved from being anatomy-based, to also incorporating functional parameters. However, none of the currently proposed classifications are directed towards decision-making, regarding the choice of inflow to the graft during transplantation and the outcomes thereof. The present scoping review i) addresses the limits of the currently available classifications in terms of surgical decisiveness, ii) clarifies the concept of physiological or non-physiological portal inflow reconstruction, and subsequently, iii) proposes a new classification of non-tumoral PVT in candidates for liver transplantation; to help tailor the surgical strategy to an individual patient, in order to provide portal inflow to the graft together with control of prehepatic portal hypertension whenever feasible. |
| doi_str_mv | 10.1016/j.jhep.2019.08.012 |
| format | Article |
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Adequate portal inflow is mandatory to ensure graft and patient survival after liver transplantation. With time, the proposed classifications of non-tumoral chronic PVT have evolved from being anatomy-based, to also incorporating functional parameters. However, none of the currently proposed classifications are directed towards decision-making, regarding the choice of inflow to the graft during transplantation and the outcomes thereof. The present scoping review i) addresses the limits of the currently available classifications in terms of surgical decisiveness, ii) clarifies the concept of physiological or non-physiological portal inflow reconstruction, and subsequently, iii) proposes a new classification of non-tumoral PVT in candidates for liver transplantation; to help tailor the surgical strategy to an individual patient, in order to provide portal inflow to the graft together with control of prehepatic portal hypertension whenever feasible.</description><identifier>ISSN: 0168-8278</identifier><identifier>EISSN: 1600-0641</identifier><identifier>DOI: 10.1016/j.jhep.2019.08.012</identifier><identifier>PMID: 31442476</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Adult ; Anastomosis, Surgical - adverse effects ; Anastomosis, Surgical - methods ; Classification ; Clinical Decision-Making - methods ; complex portal vein thrombosis ; Decision making ; Graft Survival ; Humans ; Liver ; Liver Cirrhosis - surgery ; Liver transplantation ; Liver Transplantation - adverse effects ; Liver Transplantation - methods ; non-malignant portal vein thrombosis ; Physiology ; Portal vein ; Portal Vein - pathology ; Postoperative Complications - etiology ; surgical decisiveness ; Thrombosis ; Treatment Outcome ; Venous Thrombosis - classification ; Venous Thrombosis - diagnosis</subject><ispartof>Journal of hepatology, 2019-11, Vol.71 (5), p.1038-1050</ispartof><rights>2019</rights><rights>Copyright © 2019. Published by Elsevier B.V.</rights><rights>Copyright Elsevier Science Ltd. 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Adequate portal inflow is mandatory to ensure graft and patient survival after liver transplantation. With time, the proposed classifications of non-tumoral chronic PVT have evolved from being anatomy-based, to also incorporating functional parameters. However, none of the currently proposed classifications are directed towards decision-making, regarding the choice of inflow to the graft during transplantation and the outcomes thereof. The present scoping review i) addresses the limits of the currently available classifications in terms of surgical decisiveness, ii) clarifies the concept of physiological or non-physiological portal inflow reconstruction, and subsequently, iii) proposes a new classification of non-tumoral PVT in candidates for liver transplantation; to help tailor the surgical strategy to an individual patient, in order to provide portal inflow to the graft together with control of prehepatic portal hypertension whenever feasible.</description><subject>Adult</subject><subject>Anastomosis, Surgical - adverse effects</subject><subject>Anastomosis, Surgical - methods</subject><subject>Classification</subject><subject>Clinical Decision-Making - methods</subject><subject>complex portal vein thrombosis</subject><subject>Decision making</subject><subject>Graft Survival</subject><subject>Humans</subject><subject>Liver</subject><subject>Liver Cirrhosis - surgery</subject><subject>Liver transplantation</subject><subject>Liver Transplantation - adverse effects</subject><subject>Liver Transplantation - methods</subject><subject>non-malignant portal vein thrombosis</subject><subject>Physiology</subject><subject>Portal vein</subject><subject>Portal Vein - pathology</subject><subject>Postoperative Complications - etiology</subject><subject>surgical decisiveness</subject><subject>Thrombosis</subject><subject>Treatment Outcome</subject><subject>Venous Thrombosis - classification</subject><subject>Venous Thrombosis - diagnosis</subject><issn>0168-8278</issn><issn>1600-0641</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU2P1SAUhonRONfRP-DCkLhx03qg3JYaN5OJX8lEN7omlJ7eoVKoQG_ixt8ud-7owoWrk8DzvpzwEPKcQc2Ata_ner7FtebA-hpkDYw_IDvWAlTQCvaQ7AokK8k7eUGepDQDQAO9eEwuGiYEF127I78-hyM6apxOyU7W6GyDp2GiPvhq0c4evPaZriFm7egRraf5NoZlCMmmN_SKHjY7Is2Bpi0eSt7REY1N9i7-3foDHbd4Gs4eMdIctU-rK513Lz0ljybtEj67n5fk2_t3X68_VjdfPny6vrqpjOhFrphsTDtw5NLA0KHscWi7jpm-M1MvkfVcm0aXU9OPXLcdKxd6EkIL2RsJprkkr869aww_NkxZLTYZdGURDFtSnMtuz9m-gYK-_AedwxZ92U7xhu33UKimUPxMmRhSijipNdpFx5-KgTrZUbM62VEnOwqkKnZK6MV99TYsOP6N_NFRgLdnAMtfHC1GlYxFb3C0EU1WY7D_6_8N0Tii3w</recordid><startdate>201911</startdate><enddate>201911</enddate><creator>Bhangui, Prashant</creator><creator>Lim, Chetana</creator><creator>Levesque, Eric</creator><creator>Salloum, Chady</creator><creator>Lahat, Eylon</creator><creator>Feray, Cyrille</creator><creator>Azoulay, Daniel</creator><general>Elsevier B.V</general><general>Elsevier Science Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-4839-5852</orcidid></search><sort><creationdate>201911</creationdate><title>Novel classification of non-malignant portal vein thrombosis: A guide to surgical decision-making during liver transplantation</title><author>Bhangui, Prashant ; Lim, Chetana ; Levesque, Eric ; Salloum, Chady ; Lahat, Eylon ; Feray, Cyrille ; Azoulay, Daniel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c494t-183c6b2e28c0b7e89eb6771c97cf98e192ac3a9ebc9d2a67197caf44a489c80c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Anastomosis, Surgical - adverse effects</topic><topic>Anastomosis, Surgical - methods</topic><topic>Classification</topic><topic>Clinical Decision-Making - methods</topic><topic>complex portal vein thrombosis</topic><topic>Decision making</topic><topic>Graft Survival</topic><topic>Humans</topic><topic>Liver</topic><topic>Liver Cirrhosis - surgery</topic><topic>Liver transplantation</topic><topic>Liver Transplantation - adverse effects</topic><topic>Liver Transplantation - methods</topic><topic>non-malignant portal vein thrombosis</topic><topic>Physiology</topic><topic>Portal vein</topic><topic>Portal Vein - pathology</topic><topic>Postoperative Complications - etiology</topic><topic>surgical decisiveness</topic><topic>Thrombosis</topic><topic>Treatment Outcome</topic><topic>Venous Thrombosis - classification</topic><topic>Venous Thrombosis - diagnosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bhangui, Prashant</creatorcontrib><creatorcontrib>Lim, Chetana</creatorcontrib><creatorcontrib>Levesque, Eric</creatorcontrib><creatorcontrib>Salloum, Chady</creatorcontrib><creatorcontrib>Lahat, Eylon</creatorcontrib><creatorcontrib>Feray, Cyrille</creatorcontrib><creatorcontrib>Azoulay, Daniel</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of hepatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bhangui, Prashant</au><au>Lim, Chetana</au><au>Levesque, Eric</au><au>Salloum, Chady</au><au>Lahat, Eylon</au><au>Feray, Cyrille</au><au>Azoulay, Daniel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Novel classification of non-malignant portal vein thrombosis: A guide to surgical decision-making during liver transplantation</atitle><jtitle>Journal of hepatology</jtitle><addtitle>J Hepatol</addtitle><date>2019-11</date><risdate>2019</risdate><volume>71</volume><issue>5</issue><spage>1038</spage><epage>1050</epage><pages>1038-1050</pages><issn>0168-8278</issn><eissn>1600-0641</eissn><abstract>Non-tumoral portal vein thrombosis (PVT) is present at liver transplantation in 5% to 26% of cirrhotic patients, and the prevalence of complex PVT as defined here (grade 4 Yerdel, and grade 3,4 Jamieson and Charco) has been reported in 0% to 2.2%. Adequate portal inflow is mandatory to ensure graft and patient survival after liver transplantation. With time, the proposed classifications of non-tumoral chronic PVT have evolved from being anatomy-based, to also incorporating functional parameters. However, none of the currently proposed classifications are directed towards decision-making, regarding the choice of inflow to the graft during transplantation and the outcomes thereof. 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| subjects | Adult Anastomosis, Surgical - adverse effects Anastomosis, Surgical - methods Classification Clinical Decision-Making - methods complex portal vein thrombosis Decision making Graft Survival Humans Liver Liver Cirrhosis - surgery Liver transplantation Liver Transplantation - adverse effects Liver Transplantation - methods non-malignant portal vein thrombosis Physiology Portal vein Portal Vein - pathology Postoperative Complications - etiology surgical decisiveness Thrombosis Treatment Outcome Venous Thrombosis - classification Venous Thrombosis - diagnosis |
| title | Novel classification of non-malignant portal vein thrombosis: A guide to surgical decision-making during liver transplantation |
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