Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Jul 18, 2022; 12(7): 204-210
Published online Jul 18, 2022. doi: 10.5500/wjt.v12.i7.204
Portal vein-variceal anastomosis for portal vein inflow reconstruction in orthotopic liver transplantation: A case report and review of literature
Aviad Gravetz
Aviad Gravetz, Department of Transplantation, Rabin Medical Center, Beilinson Hospital, Petach-Tikva 4941492, Israel
Author contributions: Gravetz A contributed to the manuscript drating.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The author reports no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Aviad Gravetz, MD, Surgeon, Department of Transplantation, Rabin Medical Center, Beilinson Hospital, 39 Jabotinsky Street, Petach-Tikva 4941492, Israel.
Received: December 12, 2021
Peer-review started: December 12, 2021
First decision: February 15, 2022
Revised: April 6, 2022
Accepted: June 13, 2022
Article in press: June 13, 2022
Published online: July 18, 2022

Portal vein thrombosis (PVT) is a frequent complication occurring in 5% to 26% of cirrhotic patients candidates for liver transplantation (LT). In cases of extensive portal and or mesenteric vein thrombosis, complex vascular reconstruction of the portal inflow may become necessary for a successful orthotopic LT (OLT).


A 54-year-old male with history of cirrhosis secondary to schistosomiasis complicated with extensive portal and mesenteric vein thrombosis and severe portal hypertension who underwent OLT with portal vein-left gastric vein anastomosis.


We review the various types of PVT, the portal venous inflow reconstruction techniques.

Keywords: Portal vein thrombosis, Portal inflow reconstruction, Orthotopic liver transplantation, Splanchnic varices, Left gastric varix, Case report

Core Tip: The portal vein-variceal anastomosis is a challenging physiological non-anatomical technique of portal vein inflow reconstruction used and described rarely. Herein we review the various types of portal vein thrombosis, the portal venous inflow reconstruction techniques and describe an extraordinary case of portal vein-left gastric vein anastomosis for the portal inflow reconstruction during orthotopic liver transplantation.