BACKGROUND: Portal vein thrombosis (PVT) is a well recognized complication of patients with end-stage cirrhosis and its incidence ranges from 2 to 26%. The aim of this study was to analyze the results and long-term follow-up of a consecutive series of liver transplants performed in patients with PVT and compare them with patients transplanted without PVT. PATIENTS AND METHODS: Between July 1995 and June 2006, 26 liver transplants were performed in patients with PVT (8.7%). Risk factors and variables associated with the transplant and the post-transplant period were analyzed. A comparative analysis with 273 patients transplanted without PVT was performed. RESULTS: The patients comprised 53.8% males, average age 40, 7 years. PVT was detected during surgery in 65%. Indications for transplantation were: post-necrotic cirrhosis 73%, cholestatic liver diseases 23%, and congenital liver fibrosis 4%. Child-Pugh C: 61.5%. Techniques were trombectomy in 21 patients with PVT grades I, II, IV, and extra-anatomical mesenteric graft in 5 with grade III. Morbidity was 57.7%, recurrence of PVT was 7.7%, and in-hospital mortality was 26.9%. Greater operative time, transfusion requirements, and re-operations were found in PVT patients. One-year survival was 59.6%: 75.2% for grade 1 and 44.8% for grades 2, 3, and 4. DISCUSSION: The study demonstrated a PVT prevalence of 8.7%, a higher incidence of partial thrombosis (grade 1), and successful management of PVT grade 4 with thrombectomy. Liver transplant in PVT patients was associated with an increased operative time, transfusion requirements, re-interventions, and lower survival rate according to PVT extension.
BACKGROUND: Portal vein thrombosis (PVT) is a well recognized complication of patients with end-stage cirrhosis and its incidence ranges from 2 to 26%. The aim of this study was to analyze the results and long-term follow-up of a consecutive series of liver transplants performed in patients with PVT and compare them with patients transplanted without PVT. PATIENTS AND METHODS: Between July 1995 and June 2006, 26 liver transplants were performed in patients with PVT (8.7%). Risk factors and variables associated with the transplant and the post-transplant period were analyzed. A comparative analysis with 273 patients transplanted without PVT was performed. RESULTS: The patients comprised 53.8% males, average age 40, 7 years. PVT was detected during surgery in 65%. Indications for transplantation were: post-necrotic cirrhosis 73%, cholestatic liver diseases 23%, and congenital liver fibrosis 4%. Child-Pugh C: 61.5%. Techniques were trombectomy in 21 patients with PVT grades I, II, IV, and extra-anatomical mesenteric graft in 5 with grade III. Morbidity was 57.7%, recurrence of PVT was 7.7%, and in-hospital mortality was 26.9%. Greater operative time, transfusion requirements, and re-operations were found in PVT patients. One-year survival was 59.6%: 75.2% for grade 1 and 44.8% for grades 2, 3, and 4. DISCUSSION: The study demonstrated a PVT prevalence of 8.7%, a higher incidence of partial thrombosis (grade 1), and successful management of PVT grade 4 with thrombectomy. Liver transplant in PVT patients was associated with an increased operative time, transfusion requirements, re-interventions, and lower survival rate according to PVT extension.
Authors: C Loinaz; R Gómez; C Jiménez; I González-Pinto; I García; A Gimeno; E Marqués; D Rodríguez; E Moreno González Journal: Transplant Proc Date: 2002-02 Impact factor: 1.066
Authors: Ernesto P Molmenti; Thomas W Roodhouse; Hebe Molmenti; Kshama Jaiswal; Ghap Jung; Shigeru Marubashi; Edmund Q Sanchez; Brian Gogel; Marlon F Levy; Robert M Goldstein; Carlos G Fasola; Eric E Elliott; Nevenka Bursac; David Mulligan; Thomas A Gonwa; Goran B Klintmalm Journal: Ann Surg Date: 2002-02 Impact factor: 12.969
Authors: J P Lerut; D Mazza; V van Leeuw; P F Laterre; M Donataccio; J de Ville de Goyet; B Van Beers; P Bourlier; P Goffette; T Puttemans; J B Otte Journal: Transpl Int Date: 1997 Impact factor: 3.782
Authors: A G Tzakis; P Kirkegaard; A D Pinna; E Jovine; E P Misiakos; A Maziotti; F Dodson; F Khan; J Nery; A Rasmussen; J J Fung; A Demetris; P J Ruiz Journal: Transplantation Date: 1998-03-15 Impact factor: 4.939
Authors: Ricardo Robles; Juan Angel Fernandez; Quiteria Hernández; Caridad Marín; Pablo Ramírez; Francisco Sánchez-Bueno; Juan Antonio Luján; José Manuel Rodríguez; Francisco Acosta; Pascual Parrilla Journal: Clin Transplant Date: 2004-02 Impact factor: 2.863
Authors: T J Gayowski; I R Marino; H R Doyle; L Echeverri; L Mieles; S Todo; M Wagener; N Singh; V L Yu; J J Fung; T E Starzl Journal: J Surg Res Date: 1996-02-01 Impact factor: 2.192
Authors: A C Stieber; G Zetti; S Todo; A G Tzakis; J J Fung; I Marino; A Casavilla; R R Selby; T E Starzl Journal: Ann Surg Date: 1991-03 Impact factor: 12.969
Authors: L McCormack; A Gadano; J Lendoire; O Imventarza; O Andriani; O Gil; L Toselli; L Bisigniano; E de Santibañes Journal: HPB (Oxford) Date: 2010-09 Impact factor: 3.647
Authors: Lisa B VanWagner; Brittany Lapin; Josh Levitsky; John T Wilkins; Michael M Abecassis; Anton I Skaro; Donald M Lloyd-Jones Journal: Liver Transpl Date: 2014-10-24 Impact factor: 5.799
Authors: Francesca R Ponziani; Maria A Zocco; Chiara Campanale; Emanuele Rinninella; Annalisa Tortora; Luca Di Maurizio; Giuseppe Bombardieri; Raimondo De Cristofaro; Anna M De Gaetano; Raffaele Landolfi; Antonio Gasbarrini Journal: World J Gastroenterol Date: 2010-01-14 Impact factor: 5.742