BACKGROUND: Portal vein thrombosis (PVT) represents a potentially unfavorable prognostic factor in liver transplantation (LT) for hepatocellular carcinoma (HCC). However, it is frequently difficult to establish preoperatively whether the thrombus is associated with tumor invasion or with stagnant flow. The purpose of this study was to further address this controversial issue. PATIENTS AND METHODS: We evaluated 12 consecutive patients who underwent liver transplantation for HCC in the setting of PVT. RESULTS: The origin of PVT in HCC patients could be accurately evaluated in 58% of the patients. Forty-two percent of patients had no evident portal vein invasion and only 17% of cases had tumor thrombi. One-third of patients experienced tumor recurrence within the first posttransplant year, and one-third of patients became long-term survivors (median survival of 36 months) with no evidence of tumor recurrence. One-year survival was 92%. Nine patients are currently alive after a median follow-up period of 25 months. CONCLUSIONS: PVT in the setting of HCC is characterized by poor patient outcome. However, a respectable number of instances are not accurately evaluated preoperatively, making the decision to exclude these patients from LT sometimes a challenging dilemma.
BACKGROUND: Portal vein thrombosis (PVT) represents a potentially unfavorable prognostic factor in liver transplantation (LT) for hepatocellular carcinoma (HCC). However, it is frequently difficult to establish preoperatively whether the thrombus is associated with tumor invasion or with stagnant flow. The purpose of this study was to further address this controversial issue. PATIENTS AND METHODS: We evaluated 12 consecutive patients who underwent liver transplantation for HCC in the setting of PVT. RESULTS: The origin of PVT in HCC patients could be accurately evaluated in 58% of the patients. Forty-two percent of patients had no evident portal vein invasion and only 17% of cases had tumor thrombi. One-third of patients experienced tumor recurrence within the first posttransplant year, and one-third of patients became long-term survivors (median survival of 36 months) with no evidence of tumor recurrence. One-year survival was 92%. Nine patients are currently alive after a median follow-up period of 25 months. CONCLUSIONS: PVT in the setting of HCC is characterized by poor patient outcome. However, a respectable number of instances are not accurately evaluated preoperatively, making the decision to exclude these patients from LT sometimes a challenging dilemma.
Authors: Marius Paskonis; Jonas Jurgaitis; Arianeb Mehrabi; Arash Kashfi; Hamidreza Fonouni; Kestutis Strupas; Markus W Büchler; Thomas W Kraus Journal: Clin Transplant Date: 2006 Sep-Oct Impact factor: 2.863
Authors: Georgios C Sotiropoulos; Andreas Paul; Ernesto Molmenti; Hauke Lang; Andrea Frilling; Bogdan P Napieralski; Silvio Nadalin; Jürgen Treckmann; Eirini I Brokalaki; Till Gerling; Christoph E Broelsch; Massimo Malagó Journal: Transplantation Date: 2005-10-15 Impact factor: 4.939
Authors: R Robles; J A Fernández; Q Hernández; C Marin; P Ramirez; F Sánchez Bueno; J A Luján; J M Rodriguez; F Acosta; P Parrilla Journal: Transplant Proc Date: 2003-08 Impact factor: 1.066
Authors: Nadia K Umar; Maaz B Badshah; Kumar Sandrasegaran; Marwan Ghabril; Saurabh Agarwal; Mark Tann; Marco Lacerda; Paul Y Kwo Journal: Dig Dis Sci Date: 2015-03-17 Impact factor: 3.199
Authors: Courtney B Sherman; Spencer Behr; Jennifer L Dodge; John P Roberts; Francis Y Yao; Neil Mehta Journal: Liver Transpl Date: 2019-02 Impact factor: 5.799