KINH NGHIỆM BƯỚC ĐẦU GHÉP GAN Ở BỆNH NHÂN XƠ GAN CÓ HUYẾT KHỐI TĨNH MẠCH CỬA

Abstract

Objective: Describe clinical and paraclinical characteristics, initial experience and evaluate the results of liver transplantation in patients with cirrhosis and portal vein thrombosis. Methods: Retrospective study of all patients who underwent liver transplantation due to cirrhosis with portal vein thrombosis at Viet Duc Hospital from January 2021 to June 2024. Results: There were 2 patients out of 34 patients who underwent liver transplantation during the study period. Patient 1 is a 54-year-old male diagnosed with alcoholic cirrhosis with complications of portal hypertension (grade II esophageal varices, splenomegaly) - Partial portal vein thrombosis (type 2 according to Yerdel classification, type 1 according to Jamieson classification) with MELD score of 7 points and Child-Pugh A (5 points) and patient 2 is a 42-year-old male diagnosed with hepatitis B cirrhosis with complications of portal hypertension (grade II esophageal varices with rubber band ligation, splenomegaly) - Partial portal vein thrombosis (type 1 according to both Yerdel and Jamieson classification) with MELD score of 10 points, Child-Pugh A (5 points). Both patients received liver transplants from brain-dead donors, portal vein thrombosis was removed and the portal vein was revascularized by end-to-end anastomosis. The two patients had a favorable clinical course after transplantation, were discharged after 28 days, and did not have any posttransplanted complications. currently stable at 24 and 14 months post-transplant, respectively. Conclusion: Liver transplantation for liver cirrhosis with portal vein thrombosis can be performed safely with good results. However, it is necessary to properly assess the extent of lesion to have a reasonable pre-operative, intra-operative and post-operative treatment strategies to improve the long-term results of patients.