Background. In the context of cirrhosis, portal vein thrombosis (PVT) is present in 2.1% to 26% of patients. PVTis no longer considered\nan absolute contraindication for liver transplantation, and nowadays, surgical strategies depend on the extent of PVT. Complete\nPVTis associated with higher morbidity rates and poor prognosis, while comparable long-term outcomes can be achieved as long\nas physiological portal in8ow is restored. Materials and Methods. We report our experience with a 45-year-old patient undergoing\nliver transplant with a PVT (stage III-b). To restore portal vein in8ow to the liver, an extra-anatomic jump graft from the right\ncolic vein with donor iliac vein interposition was constructed. Results. )e patient recovered well, with a progressive improvement\nof the general conditions, and was ;nally discharged on p.o.d. 14. No anastomotic defects were found at the postoperative CTscan\n10 months after the surgery. Conclusion. Our technical innovation represents a valid and safe alternative to the cavoportal\nhemitransposition, providing a proper 8ow restoration and reproducing a physiological setting, while avoiding the complications\nrelated to the cavoportal shunt. We believe that the reconstitution of liver portal in8ow should be obtained with the most\nphysiological approach possible and considering long-term liver function.
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