{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T04:58:25Z","timestamp":1786251505361,"version":"build-2736575974"},"reference-count":50,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2022,8,21]],"date-time":"2022-08-21T00:00:00Z","timestamp":1661040000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Natural Science Foundation of China","award":["81270521"],"award-info":[{"award-number":["81270521"]}]},{"name":"National Natural Science Foundation of China","award":["81870445"],"award-info":[{"award-number":["81870445"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Portal vein thrombosis (PVT) after adult liver transplantation (LT) is a rare but serious complication with no consensus on the ideal treatment. We report a case series and a comprehensive review of the literature on PVT after LT to discuss the therapeutic options. Methods: The clinical data of 360 adult patients (\u226518 years of age) who underwent LT from January 2017 to January 2020 were reviewed, and a comprehensive search of PubMed and Web of Science was conducted. Patients diagnosed with PVT after LT were identified, and relevant risk factors and therapies were analyzed. Results: Among the 360 patients, 7 (1.94%) developed PVT after LT. Onset of PVT within one week after LT was found in six patients (85.71%). Four of the seven patients with PVT received systemic anticoagulation (low molecular weight heparin and warfarin) therapy. Minimally invasive interventional therapies combined with systemic anticoagulation (heparin and warfarin) were applied for three patients, two of whom died because of severe abdominal hemorrhage and liver failure. Of the 33 cases reported in the literature, minimally invasive interventional therapy combined with systematic anticoagulation or sclerotherapy were the most-used methods (20\/33). Systemic anticoagulation was administered to four patients, and surgical operation (thrombectomy; portosystemic shunt and retransplantation) was performed for nine patients. Among these 33 patients, 4 eventually died. Conclusions: Interventional therapy combined with systemic anticoagulation is a good choice for the management of PVT after LT, and in our experience, systemic anticoagulation alone can also have a positive effect for early PVT patients.<\/jats:p>","DOI":"10.3390\/jcm11164909","type":"journal-article","created":{"date-parts":[[2022,8,21]],"date-time":"2022-08-21T23:51:01Z","timestamp":1661125861000},"page":"4909","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["The Management of Portal Vein Thrombosis after Adult Liver Transplantation: A Case Series and Review of the Literature"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8288-592X","authenticated-orcid":false,"given":"Liang-Shuo","family":"Hu","sequence":"first","affiliation":[{"name":"Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi\u2019an Jiaotong University, No. 277, West Yanta Road, Xi\u2019an 710061, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi\u2019an Jiaotong University, No. 277, West Yanta Road, Xi\u2019an 710061, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi\u2019an Jiaotong University, No. 277, West Yanta Road, Xi\u2019an 710061, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin-Shan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi\u2019an Jiaotong University, No. 277, West Yanta Road, Xi\u2019an 710061, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi\u2019an Jiaotong University, No. 277, West Yanta Road, Xi\u2019an 710061, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi\u2019an Jiaotong University, No. 277, West Yanta Road, Xi\u2019an 710061, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/0002-9610(91)90364-J","article-title":"Vascular complications after orthotopic liver transplantation","volume":"161","author":"Langnas","year":"1991","journal-title":"Am. J. Surg."},{"key":"ref_2","first-page":"384295","article-title":"Concurrent hepatic artery and portal vein thrombosis after orthotopic liver transplantation with preserved allografts","volume":"2014","author":"Khan","year":"2014","journal-title":"Case Rep. Transplant."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1002\/lt.24011","article-title":"Management of portal vein thrombosis after liver transplantation with a combined open and endovascular approach","volume":"21","author":"Kensinger","year":"2015","journal-title":"Liver Transpl."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1111\/j.1399-0012.2007.00728.x","article-title":"Management of portal vein thrombosis in liver transplantation: Influence on morbidity and mortality","volume":"21","author":"Llado","year":"2007","journal-title":"Clin. Transplant."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1016\/j.jamcollsurg.2008.12.032","article-title":"Vascular complications of orthotopic liver transplantation: Experience in more than 4200 patients","volume":"208","author":"Duffy","year":"2009","journal-title":"J. Am. Coll. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"4636","DOI":"10.3748\/wjg.v13.i34.4636","article-title":"Postoperative complications in patients with portal vein thrombosis after liver transplantation: Evaluation with Doppler ultrasonography","volume":"13","author":"Jia","year":"2007","journal-title":"World J. Gastroenterol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"3087","DOI":"10.1016\/j.transproceed.2004.10.065","article-title":"Simultaneous hepatic artery and portal vein thrombosis after living donor liver transplantation","volume":"36","author":"Kaneko","year":"2004","journal-title":"Transplant. Proc."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1097\/00000658-200211000-00017","article-title":"Long-term venous complications after full-size and segmental pediatric liver transplantation","volume":"236","author":"Buell","year":"2002","journal-title":"Ann. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1111\/j.1432-2277.2008.00752.x","article-title":"Portal vein complications after adult-to-adult living donor liver transplantation","volume":"21","author":"Kyoden","year":"2008","journal-title":"Transpl. Int."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1124","DOI":"10.1097\/00007890-199804270-00018","article-title":"Percutaneous thrombolysis and stent placement for the treatment of portal vein thrombosis after liver transplantation: Long-term follow-up","volume":"65","author":"Cherukuri","year":"1998","journal-title":"Transplantation"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1016\/S1051-0443(94)71562-1","article-title":"Portal Vein Thrombolysis and Closure of Competitive Shunts Following Liver Transplantation","volume":"5","author":"Durham","year":"1994","journal-title":"J. Vasc. Interv. Radiol."},{"key":"ref_12","first-page":"924","article-title":"Orthotopic liver transplantation: Nonoperative management of early, acute portal vein thrombosis","volume":"104","author":"Burke","year":"1988","journal-title":"Surgery"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"E120","DOI":"10.1111\/j.1399-3046.2011.01548.x","article-title":"Unusual shunt for symptomatic portal vein thrombosis after liver transplantation\u2014Clatworthy revisited","volume":"16","author":"Mali","year":"2012","journal-title":"Pediatr Transpl."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1007\/s00270-005-0046-8","article-title":"Endovascular treatment of acute portal vein thrombosis after liver transplantation in a child","volume":"29","author":"Carnevale","year":"2006","journal-title":"Cardiovasc. Interv. Radiol"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1739","DOI":"10.1016\/S0041-1345(00)02663-4","article-title":"Extrahilar mesenterico-left portal shunt for portal vein thrombosis after liver transplantation","volume":"33","author":"Stenger","year":"2001","journal-title":"Transpl. Proc."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1097\/TP.0000000000003235","article-title":"The Impact of Portal Vein Thrombosis on Liver Transplant Outcomes: Does Grade or Flow Rate Matter?","volume":"105","author":"Rizzari","year":"2021","journal-title":"Transplantation"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1097\/TP.0b013e3181b11fa7","article-title":"Catheter-directed tissue plasminogen activator infusion and concurrent systemic anticoagulation with heparin to treat portal vein thrombosis post orthoptic liver transplantation","volume":"88","author":"Gill","year":"2009","journal-title":"Transplantation"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1111\/j.1399-0012.2008.00822.x","article-title":"Endovascular management of early portal vein thrombosis caused by coronary vein steal after liver transplantation and its outcome","volume":"22","author":"Koo","year":"2008","journal-title":"Clin. Transplant."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1034\/j.1600-6143.2001.001003284.x","article-title":"Rescue of acute portal vein thrombosis after liver transplantation using a cavoportal shunt at retransplantation","volume":"1","author":"Bakthavatsalam","year":"2001","journal-title":"Am. J. Transplant."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1016\/j.transproceed.2004.02.040","article-title":"Successful minimally invasive management of late portal vein thrombosis after splenectomy due to splenic artery steal syndrome following liver transplantation: A case report","volume":"36","author":"Baccarani","year":"2004","journal-title":"Transplant. Proc."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1111\/j.1432-2277.1999.tb01213.x","article-title":"Successful recanalization of late portal vein thrombosis after liver transplantation using systemic low-dose recombinant tissue plasminogen activator","volume":"12","author":"Guckelberger","year":"1999","journal-title":"Transpl. Int."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1002\/lt.23612","article-title":"Thrombolysis of portal vein thrombosis after splenectomy following liver transplantation","volume":"19","author":"Brown","year":"2013","journal-title":"Liver Transplant."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1007\/s10620-009-0735-2","article-title":"Transjugular intrahepatic portosystemic shunt with thrombectomy for the treatment of portal vein thrombosis after liver transplantation","volume":"55","author":"Lodhia","year":"2010","journal-title":"Dig. Dis. Sci."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1016\/S1051-0443(93)71974-0","article-title":"Treatment of Portal Vein Thrombosis after Liver Transplantation with Percutaneous Thrombolysis and Stent Placement","volume":"4","author":"Haskal","year":"1993","journal-title":"J. Vasc. Interv. Radiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1272\/jnms.83.206","article-title":"Interventional Treatment of Severe Portal Vein Thrombosis after Living-Donor Liver Transplantation","volume":"83","author":"Kawano","year":"2016","journal-title":"J. Nippon Med. Sch."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1016\/j.transproceed.2013.11.095","article-title":"Intrahepatic segmental portal vein thrombosis after living-related donor liver transplantation","volume":"46","author":"Jeng","year":"2014","journal-title":"Transplant. Proc."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1016\/j.transproceed.2012.01.042","article-title":"The inferior mesenteric vein to the left gonadal vein shunt for gastroesophageal varices and extrahepatic portal vein thrombosis after living donor liver transplantation: A case report","volume":"44","author":"Kobayashi","year":"2012","journal-title":"Transplant. Proc."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1097\/00007890-199702270-00021","article-title":"Intraoperative placement of a Wallstent for portal vein stenosis and thrombosis after liver transplantation","volume":"63","author":"McDaniel","year":"1997","journal-title":"Transplantation"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/S1051-0443(90)72496-7","article-title":"Percutaneous Transhepatic Portal Vein Angioplasty and Stent Placement after Liver Transplantation: Early Experience","volume":"1","author":"Olcott","year":"1990","journal-title":"J. Vasc. Interv. Radiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2195","DOI":"10.1097\/00007890-200005270-00042","article-title":"Percutaneous portal vein thrombolysis and endovascular stent for management of posttransplant portal venous conduit thrombosis","volume":"69","author":"Bhattacharjya","year":"2000","journal-title":"Transplantation"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1097\/00007890-200107150-00030","article-title":"Transjugular intrahepatic portosystemic shunt approach and local thrombolysis for treatment of early posttransplant portal vein thrombosis","volume":"72","author":"Ciccarelli","year":"2001","journal-title":"Transplantation"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1572","DOI":"10.1097\/00007890-200111150-00016","article-title":"Percutaneous mechanical fragmentation and stent placement for the treatment of early posttransplantation portal vein thrombosis","volume":"72","author":"Baccarani","year":"2001","journal-title":"Transplantation"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1016\/j.asjsur.2019.11.023","article-title":"Successful rescue of a liver graft by re-implantation and portal stent for portal vein thrombosis after living donor liver transplant","volume":"43","author":"Hung","year":"2020","journal-title":"Asian J. Surg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e13075","DOI":"10.1111\/tid.13075","article-title":"Disseminated phaeohyphomycosis with hepatic artery and portal vein thrombosis caused by Pleurostomophora richardsiae in a liver transplant recipient: A case report","volume":"21","author":"Sribenjalux","year":"2019","journal-title":"Transpl. Infect. Dis."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"653","DOI":"10.6002\/ect.2019.0273","article-title":"Endovascular Treatment of Acute Posttransplant Portal Vein Thrombosis Due to Portal Steal From Mesocaval And Coronary Portosystemic Shunts","volume":"18","author":"Centonze","year":"2020","journal-title":"Exp. Clin. Transplant."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"418","DOI":"10.6002\/ect.2016.0259","article-title":"Portal Vein Thrombosis and Nephrotic Syndrome After Liver Transplant","volume":"17","author":"Dumortier","year":"2019","journal-title":"Exp. Clin. Transplant."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1097\/00000658-199112000-00009","article-title":"Liver transplantation in patients with portal vein thrombosis and central portacaval shunts","volume":"214","author":"Shaked","year":"1991","journal-title":"Ann. Surg."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1174","DOI":"10.1097\/00007890-199404270-00006","article-title":"Incidence, risk factors, management, and outcome of portal vein abnormalities at orthotopic liver transplantation","volume":"57","author":"Davidson","year":"1994","journal-title":"Transplantation"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1016\/S0140-6736(88)92597-4","article-title":"Protein C deficiency and portal thrombosis in liver transplantation in children","volume":"2","author":"Harper","year":"1988","journal-title":"Lancet"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1034\/j.1399-0012.2000.140309.x","article-title":"Venous complications after orthotopic liver transplantation","volume":"14","author":"Settmacher","year":"2000","journal-title":"Clin. Transplant."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1016\/j.transproceed.2010.02.037","article-title":"Vascular complications after deceased and living donor liver transplantation: A single-center experience","volume":"42","author":"Khalaf","year":"2010","journal-title":"Transplant. Proc."},{"key":"ref_42","first-page":"121","article-title":"Current state of art management for vascular complications after liver transplantation","volume":"6","author":"Zimmerman","year":"2014","journal-title":"Middle East J. Dig. Dis."},{"key":"ref_43","first-page":"67","article-title":"Distal splenorenal shunt for portal vein thrombosis after liver transplantation","volume":"84","author":"Marino","year":"1989","journal-title":"Am. J. Gastroenterol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2261","DOI":"10.1111\/ajt.13243","article-title":"Percutaneous Retroperitoneal Splenorenal Shunt for Symptomatic Portal Vein Thrombosis After Liver Transplantation","volume":"15","author":"Pulitano","year":"2015","journal-title":"Am. J. Transplant."},{"key":"ref_45","first-page":"35","article-title":"Vascular complications after orthotopic liver transplantation","volume":"9","author":"Novruzbekov","year":"2017","journal-title":"Transplantologiya"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1002\/lt.23583","article-title":"Management and long-term consequences of portal vein thrombosis after liver transplantation in children","volume":"19","author":"Jensen","year":"2013","journal-title":"Liver Transplant."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1007\/BF02576985","article-title":"Hepatopetal collaterals after portal vein thrombosis following liver transplantation","volume":"9","author":"Zajko","year":"1986","journal-title":"Cardiovasc. Interv. Radiol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1633","DOI":"10.1053\/gast.1996.v110.pm8613072","article-title":"Mesenteric venous thrombosis treated with urokinase via the superior mesenteric artery","volume":"110","author":"Poplausky","year":"1996","journal-title":"Gastroenterology"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1002\/lt.500040305","article-title":"Percutaneous mesenteric venous thrombectomy and thrombolysis: Successful treatment followed by liver transplantation","volume":"4","author":"Ryu","year":"1998","journal-title":"Liver Transplant. Surg."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"100630","DOI":"10.1016\/j.trre.2021.100630","article-title":"Portal vein obstruction after pediatric liver transplantation: A systematic review of current treatment strategies","volume":"35","author":"Alfares","year":"2021","journal-title":"Transplant. Rev."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/16\/4909\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:13:13Z","timestamp":1760141593000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/16\/4909"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,21]]},"references-count":50,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2022,8]]}},"alternative-id":["jcm11164909"],"URL":"https:\/\/doi.org\/10.3390\/jcm11164909","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,21]]}}}