"Pants" vein jump graft for portal vein and superior mesenteric vein thrombosis in transplantation of the liver.

PORTAL VEIN TlIROMBOSIS (PVT) or thrombosis of its tributaries has been a formidable surgical challenge in orthotopic hepatic transplantation (OHT). At one time, PVT was considered a relative contraindication for OHT. However, refinements of the technique to reconstruct the portal vein after thrombosis have included venous grafting procedures (1, 2). The technique of the venous "jump" graft from the superior mesenteric vein (SMV) for PVT has been standardized and should be considered in cases of PVT to establish portal flow to the hepatic allograft (1-5). One of the limiting factors of the venous jump-graft technique is the lack of a sufficient segment of SMV from which the venous graft can be anastomosed. Herein, we report a technique of anastomosing two iliac venous allografts separately to two jejunal branches of the SMV to reconstitute portal vein flow to the hepatic allograft in a patient with both portal vein and SMV thrombosis.