Portal Vein Thrombosis and Arterioportal Shunting Due To Chronic Cholangitis: A Rare Complication of Living-Donor Liver Transplant

Exp Clin Transplant. 2017 Aug;15(4):474-476. doi: 10.6002/ect.2015.0013. Epub 2016 Jan 20.

Abstract

Objectives: We present a patient with portal vein thrombosis due to chronic cholangitis after undergoing a living-donor liver transplant.

Case presentation: A 52-year-old woman with a history of hepatitis B virus-related liver cirrhosis underwent a living-donor liver transplant. After the surgery, the patient had recurrent episodes of cholangitis because of common and intrahepatic bile duct stricture. Biliary stricture because of cholangitis eventually resulted in acute portal vein thrombosis. A stent was inserted by percutaneous transluminal portography. Blood flow through the portal vein progressively improved from the third through the 10th day after stent placement. The anticoagulation regimen was change to acetylsalicylic acid and clopidogrel hydrogen sulfate (Plavix). On poststenting day 10, a follow-up computed tomographic scan showed good patency of the main portal vein and no evidence of arterioportal shunting.

Conclusions: Cholangitis after living-donor liver transplant is a rare cause of portal vein thrombosis. Regular follow-up examinations with color Doppler ultrasound are required to monitor portal vein flow in patients with biliary complications after living-donor liver transplant.

Publication types

  • Case Reports

MeSH terms

  • Anticoagulants / therapeutic use
  • Cholangitis / diagnostic imaging
  • Cholangitis / etiology*
  • Cholangitis / therapy
  • Chronic Disease
  • Computed Tomography Angiography
  • Female
  • Humans
  • Liver Transplantation / adverse effects*
  • Liver Transplantation / methods
  • Living Donors*
  • Middle Aged
  • Phlebography / methods
  • Portal Vein* / diagnostic imaging
  • Portography / methods
  • Recurrence
  • Stents
  • Time Factors
  • Treatment Outcome
  • Venous Thrombosis / diagnostic imaging
  • Venous Thrombosis / etiology*
  • Venous Thrombosis / therapy

Substances

  • Anticoagulants