Evidence map›Paper›PMID 42808779›Full record

ArticleClinical transplantation2026

Outcomes of a Modified Portal Venovenous Bypass Technique During Liver Transplantation in High-MELD Recipients.

Michael G Megaly, Daniel C Waller, David Matthews, Andrew Adams, Timothy L Pruett, Karthik Ramanathan, Raja Kandaswamy, Erik B Finger, Hannah Sutherland, Vanessa Humphreville and 1 more

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Article in Clinical transplantation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Michael G MegalyDivision of Transplantation, Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
Daniel C WallerDivision of Biostatistics and Health Data Science, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA.
David MatthewsDivision of Transplantation, Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
Andrew AdamsDivision of Transplantation, Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
Timothy L PruettDivision of Transplantation, Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
Karthik RamanathanDivision of Transplantation, Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
Raja KandaswamyDivision of Transplantation, Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
Erik B FingerDivision of Transplantation, Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
Hannah SutherlandUniversity of Minnesota Physicians, Minneapolis, Minnesota, USA.
Vanessa HumphrevilleDivision of Transplantation, Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
Srinath ChinnakotlaDivision of Transplantation, Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlthough portal (venovenous) bypass (pVVB) is uncommon in liver transplantation (LT), it may provide some advantages, particularly for high-acuity recipients.

methodsTo examine its use in high-risk patients, we retrospectively evaluated outcomes of a modified pVVB technique among adult LT recipients at a single center, stratified by MELD score (≥35 vs. <35). Primary outcomes were patient and graft survival evaluated withKaplan-Meier estimates and multivariable Cox regression; secondary outcomes included biliary complications, transfusion requirements, viscoelastic parameters, laboratory trends, length of stay, readmission, and need for dialysis.

resultsBetween January 2016 and July 2025, 548 patients underwent LT with pVVB; 111 (20.3%) had MELD ≥35. Despite greater baseline severity, higher transfusion requirements, and longer postoperative ICU stay, MELD ≥35 was not associated with increased risk of graft failure (HR 1.19; 95% CI 0.72-1.96), mortality (HR 0.86; 95% CI 0.46-1.61), or biliary complications (HR 1.02; 95% CI 0.65-1.60). Post-reperfusion viscoelastic measures were similar across groups. Dialysis was more frequent before and after LT in MELD ≥35. No complications or deaths were attributable to pVVB.

conclusionAmong LT recipients treated with pVVB, MELD ≥35 was not significantly associated with graft failure, mortality, or biliary complications. These findings support the feasibility of pVVB in high-acuity recipients.

Indexed as

End Stage Liver DiseaseGraft RejectionLiver TransplantationPortal VeinPostoperative ComplicationsSeverity of Illness IndexAdultFemaleFollow-Up StudiesGraft SurvivalHumansMaleMiddle AgedPrognosisRetrospective StudiesRisk Factorsliver transplantmodel for end‐stage liver diseaseportal venovenous bypass

Identifiers

PMID42808779
PMCPMC13621918

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.