BACKGROUND: There is a lack of agreement regarding preexisting portal vein thrombosis (PVT) in patients undergoing living donor liver transplantation (LDLT). We report the results of a single-center study to determine the impact of PVT on outcomes of adult LDLT recipients. METHODS: Of 133 cases of adult LDLT performed between January 2000 and December 2004, a thrombectomy was performed on 22 patients (16.5%) with PVT during the transplant procedure. One hundred eleven patients without PVT (group 1) were compared with those with a thrombosis confined to the portal vein (group 2; n = 15) and patients with the thrombosis beyond the portal vein (group 3; n = 7). RESULTS: The sensitivities of Doppler ultrasound and CT in detecting PVT were 50 and 63.6%. A prior history of variceal bleeding (OR = 10.6, p = 0.002) and surgical shunt surgery (OR = 28.1, p = 0.044) were found to be an independent risk factors for PVT. The rate of postoperative PVT was significantly higher in patients with PVT than in those without (18.2 vs. 2.7%; p = 0.014). In particular, the rethrombosis rate in group 3 was 28.6%. The actuarial 3-year patient survival rate in PVT patients (73.6%) was similar to that of the non-PVT patients (85.3%; p = 0.351). However, the actuarial 3-year patient survival rate in group 3 was 38.1%, which was significantly lower than that in groups 1 and 2 (p = 0.006). CONCLUSION: A thrombosis confined to the portal vein per se should not be considered a contraindication for LDLT.
BACKGROUND: There is a lack of agreement regarding preexisting portal vein thrombosis (PVT) in patients undergoing living donor liver transplantation (LDLT). We report the results of a single-center study to determine the impact of PVT on outcomes of adult LDLT recipients. METHODS: Of 133 cases of adult LDLT performed between January 2000 and December 2004, a thrombectomy was performed on 22 patients (16.5%) with PVT during the transplant procedure. One hundred eleven patients without PVT (group 1) were compared with those with a thrombosis confined to the portal vein (group 2; n = 15) and patients with the thrombosis beyond the portal vein (group 3; n = 7). RESULTS: The sensitivities of Doppler ultrasound and CT in detecting PVT were 50 and 63.6%. A prior history of variceal bleeding (OR = 10.6, p = 0.002) and surgical shunt surgery (OR = 28.1, p = 0.044) were found to be an independent risk factors for PVT. The rate of postoperative PVT was significantly higher in patients with PVT than in those without (18.2 vs. 2.7%; p = 0.014). In particular, the rethrombosis rate in group 3 was 28.6%. The actuarial 3-year patient survival rate in PVT patients (73.6%) was similar to that of the non-PVT patients (85.3%; p = 0.351). However, the actuarial 3-year patient survival rate in group 3 was 38.1%, which was significantly lower than that in groups 1 and 2 (p = 0.006). CONCLUSION: A thrombosis confined to the portal vein per se should not be considered a contraindication for LDLT.
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: E Moreno González; I García García; R Gómez Sanz; I González-Pinto; C Loinaz Segurola; C Jiménez Romero Journal: Br J Surg Date: 1993-01 Impact factor: 6.939
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: D H Van Thiel; R R Schade; T E Starzl; S Iwatsuki; B W Shaw; J S Gavaler; M Dugas Journal: Hepatology Date: 1982 Sep-Oct Impact factor: 17.425
Authors: K T Werner; Shawna Sando; Elizabeth J Carey; Hugo E Vargas; Thomas J Byrne; David D Douglas; M E Harrison; Jorge Rakela; Bashar A Aqel Journal: Dig Dis Sci Date: 2013-01-12 Impact factor: 3.199
Authors: Lucas S Nacif; Leonardo Y Zanini; Rafael S Pinheiro; Daniel R Waisberg; Vinicius Rocha-Santos; Wellington Andraus; Flair J Carrilho; Luiz Carneiro-D'Albuquerque Journal: Clinics (Sao Paulo) Date: 2021-01-22 Impact factor: 2.365