Liver transplantation in patients with portal vein thrombosis
Authors:
Libor Janoušek 1; Miloš Adamec 1; Martin Oliverius 1; Pavel Trunečka 2; Miloš Kučera 1
Authors‘ workplace:
Institut klinické a experimentální medicíny Praha, Klinika transplantační chirurgie
1; Institut klinické a experimentální medicíny Praha, Transplantcentrum
2
Published in:
Čas. Lék. čes. 2011; 150: 72-74
Category:
Original Article
Overview
Background:
Portal vein thrombosis has (PVT) long been an absolute contraindication to liver transplantation. In patients scheduled for liver transplantation, portal vein thrombosis occurs in 4–15%.
Methods and results:
The authors retrospectively collected data on 740 patients who underwent an initial orthotopic liver transplant at the authors’ institution between 1996 and 2009. Mean follow-up was from 1 day to 6 years. There were 437 male patients and 303 female patients. We have performed this procedure in 57 recipients with PVT; this constitutes 7.7% of the overall transplant population. There was a 10.5% incidence of liver graft dysfunction, 10.5% of hepatic artery thrombosis, 19.3% of acute rejection and 17.5% of biliary complications. The overall incidence of relaparotomy for bleeding was 28% (16 patients). In-hospital mortality and late mortality were 15.8% and 31.6%, respectively. Volumes transfused were 17.1 (0–425) transfusion units of red blood cell, 27.1 (0–132) of fresh-frozen plasma and 2.6 (0–20) of platelets respectively.
Conclusions:
We confirm that PVT is not a contraindication to LTx at the present time.
Key words:
portal vein thrombosis, liver transplantation.
Sources
1. van Thiel DH, Schade RR, Starzl TE, Iwatsuki S, Shaw BW, Jr, Gavaler JS, Dugas M. Liver transplantation in patients with portal vein thrombosis. Hepatology 1982; 2(5): 637–640.
2. Stieber AC, Zetti G, Todo S, et al. The spectrum of portal vein thrombosis in liver transplantation. Ann Surg 1991; 213: 199–206.
3. Seu P, Shackleton CR, Shaked A, et al. Improved results of liver transplantation in patients with portal vein thrombosis. Arch Surg 1996; 131: 840–4; discussion 4–5.
4. Molmenti EP, Roodhouse TW, Molmenti H, et al. Thrombendvenectomy for organized portal vein thrombosis at the time of liver transplantation. Ann Surg 2002; 235: 292–296.
5. Dumortier J, Czyglik O, Poncet G, et al. Eversion thrombectomy for portal vein thrombosis during liver transplantation. Am J Transplant 2002; 2: 934–938.
6. Janssen HL, einardi JR, leggaar FP, an Uum SH, aagsma EB, an Der Meer FJ, an Hattum J, et al. Factor V Leiden mutation, prothrombin gene mutation and definciensis in coagulation inhibitors associated with Budd-Chiari syndrome and portal vein thrombosis: results of a case-control study. Blood Coagul Fibrinolysis 2000; 96: 2364–2368.
7. Francoz C, Belghiti J, Vilgrain V, et al. Splanchnic vein thrombosis in candidates for liver transplantation: usefulness of screening and anticoagulation. Gut 2005; 54: 691–697.
8. Carr BI, Buch SC, Kondragunta V, Pancoska P, Branch RA. Tumor and liver determinants of prognosis in unresectable hepatocellular carcinoma: a case cohort study. J Gastroenterol Hepatol 2008; 23: 1259–1266.
9. Yerdel MA, Gunson B, Mirza D, et al. Portal vein thrombosis in adults undergoing liver transplantation: risk factors, screening, management, and outcome. Transplantation 2000; 69: 1873–1881.
10. Englesbe MJ, Schaubel DE, Cai S, Guidinger MK, Merion RM. Portal vein thrombosis and liver transplant survival benefit. Liver Transpl 2010; 16: 999–1005.
11. Manzanet G, Sanjuan F, Orbis P, et al. Liver transplantation in patients with portal vein thrombosis. Liver Transpl 2001; 7: 125–131.
12. Shaw BW, watsuki S, Bron K, Starzl TE. Portal vein grafts in hepatic transplantation. Surg Gynecol Obstet 1985: 161(1): 66–68.
13. Langnas AN, Marujo WC, Stratta RJ, et al. A selective approach to preexisting portal vein thrombosis in patients undergoing liver transplantation. Am J Surg 1992; 163: 132–136.
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Journal of Czech Physicians
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