Skip to main content
OpenTrials
Completed

NCT Number: NCT07192653

Intraoperative Endovascular Treatment Via the Ligamentum Teres Hepatis in Liver Transplantation for Yerdel Grade Ⅲ/IV Portal Vein Thrombosis: A Safe and Effective Strategy

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.

Completed

Looking for future studies?

Notify Me

Key information

Conditions

Liver Transplantation Endovascular Treatment

Age range

18 year and older

Sex eligibility

All sexes

Study type

Observational

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Adult patients (aged ≥18 years).
  • Patients underwent deceased-donor liver transplantation.
  • At Tianjin First Central Hospital between February 2016 and December 2024.
  • Identified recipients with Yerdel grade III/IV PVT, which was confirmed by multiphase contrast-enhanced CT, indirect portography, and intraoperative evaluation

Exclusion criteria

  • Exclusion criteria were living-donor and split-liver procedures.
  • All procedures were performed using classic orthotopic transplantations.

Treatment and study plan

nonanatomical anastomosis

Procedure

In Period 1 (2016-2019, n=41), nonanatomical anastomosis was performed if portal flow was insufficient.

LTH-based EVT

Procedure

In Period 2 (2019-2024, n=34), patients with persistent hypoperfusion underwent additional LTH-based EVT (stenting or shunt occlusion)

Primary outcomes

  1. Operative Time

    Time frame: Intraoperative

    Operative time refers to the duration from the initial surgical incision to the completion of skin closure.

  2. Anhepatic Phase Time

    Time frame: Intraoperative

    The anhepatic phase time is the critical period during liver transplant surgery when the patient's native liver has been removed and the donor liver has not yet been reperfused.

  3. Rate of Nonanatomical Reconstruction

    Time frame: Intraoperative

    The rate of nonanatomical resection refers to the frequency with which a surgical procedure removes a tumor without following the boundaries of the organ's functional anatomical units.

  4. Delayed Graft Function

    Time frame: Within 7 days postoperatively

    Delayed graft function is a common complication following kidney transplantation where the transplanted organ does not function immediately, often necessitating dialysis within the first week post-surgery.

  5. Portal Vein Complications

    Time frame: From the surgery to the last follow-up (median follow-up 28 months)

    Portal vein complications are a serious concern in liver transplantation, encompassing issues such as thrombosis, stenosis, and occlusion that can threaten graft survival and patient life.

  6. Graft Survival

    Time frame: 1-year and 3-year postoperatively

    Graft survival refers to the continued functional existence of a transplanted organ or tissue within a recipient's body.

Sponsors and collaborators

Lead sponsor

Chiyi Chen

Other

Registry information

Important dates

Study start
2016
Primary completion
2024
Study completion
2025
First posted
Sep 25, 2025
Registry last updated
Sep 25, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Related clinical trials

Published trials that share one or more normalized conditions with this study.