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.
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Operative Time
Timeframe: Intraoperative
Anhepatic Phase Time
Timeframe: Intraoperative
Rate of Nonanatomical Reconstruction
Timeframe: Intraoperative
Delayed Graft Function
Timeframe: Within 7 days postoperatively
Portal Vein Complications
Timeframe: From the surgery to the last follow-up (median follow-up 28 months)
Graft Survival
Timeframe: 1-year and 3-year postoperatively