Intraoperative Endovascular Treatment Via the Ligamentum Teres Hepatis in Liver Transplantation for Yerdel Grade Ⅲ/IV Portal Vein Thrombosis: A Safe and Effective Strategy
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 75
- 主要终点
- Rate of Nonanatomical Reconstruction
研究概览
简要总结
Background: To evaluate the safety and efficacy of intraoperative endovascular treatment (EVT) using the donor ligamentum teres hepatis (LTH) approach for Yerdel grade III/IV portal vein thrombosis (PVT) during liver transplantation (LT), a condition that poses a major challenge in complex surgeries.
Methods: This single-center retrospective cohort study included some patients with grade III/IV PVT who underwent LT and were divided into two periods: in both periods, patients underwent modified eversion thrombectomy. However, in Period 1 (2016-2019), nonanatomical anastomosis was performed if portal flow was insufficient, and in Period 2 (2019-2024), patients with persistent hypoperfusion underwent additional LTH-based EVT (stenting or shunt occlusion). Perioperative outcomes (operative time, anhepatic phase, and anastomosis type) and long-term outcomes (graft survival and complication rates) were compared between groups.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adult patients (aged ≥18 years).
- •Patients underwent deceased-donor liver transplantation.
- •At Tianjin First Central Hospital between February 2016 and December
- •Identified recipients with Yerdel grade III/IV PVT, which was confirmed by multiphase contrast-enhanced CT, indirect portography, and intraoperative evaluation
排除标准
- •Exclusion criteria were living-donor and split-liver procedures.
- •All procedures were performed using classic orthotopic transplantations.
结局指标
主要结局
Rate of Nonanatomical Reconstruction
时间窗: Intraoperative
The rate of nonanatomical resection refers to the frequency with which a surgical procedure removes a tumor without following the boundaries of the organ's functional anatomical units.
Operative Time
时间窗: Intraoperative
Operative time refers to the duration from the initial surgical incision to the completion of skin closure.
Anhepatic Phase Time
时间窗: Intraoperative
The anhepatic phase time is the critical period during liver transplant surgery when the patient's native liver has been removed and the donor liver has not yet been reperfused.
Portal Vein Complications
时间窗: From the surgery to the last follow-up (median follow-up 28 months)
Portal vein complications are a serious concern in liver transplantation, encompassing issues such as thrombosis, stenosis, and occlusion that can threaten graft survival and patient life.
Graft Survival
时间窗: 1-year and 3-year postoperatively
Graft survival refers to the continued functional existence of a transplanted organ or tissue within a recipient's body.
Delayed Graft Function
时间窗: Within 7 days postoperatively
Delayed graft function is a common complication following kidney transplantation where the transplanted organ does not function immediately, often necessitating dialysis within the first week post-surgery.
次要结局
未报告次要终点
研究者
Chiyi Chen
Attending physician
Tianjin First Central Hospital