Effect of preoperative devascularization and impact of gastrointestinal hemorrhage on the efficacy of liver transplantation for cirrhotic portal hypertension patients

Abstract

Objective To evaluate the effect of preoperative devascularization and the impact of gastrointestinal hemorrhage on the efficacy of liver transplantation for cirrhotic portal hypertension patients. Methods Clinical data of 110 patients with cirrhotic portal hypertension undergoing liver transplantation in the 900th Hospital of PLA Joint Logistics Support Force from January 2005 to December 2015 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 84 patients were male and 26 female, aged 7-75 years with a median of 46 years. According to the history of preoperative devascularization and gastrointestinal hemorrhage, the patients were divided into the devascularization (n=19) and non-devascularization (n=91) groups, hemorrhage (n=66) and non-hemorrhage groups (n=44). The effect of preoperative devascularization and gastrointestinal hemorrhage on prognosis of patients was evaluated. Intraoperative blood loss and infusion volume between two groups were compared by t test. The rate comparison was performed by Chi-square test. Results The incidence of postoperative complications and the 5-year cumulative survival rate in devascularization group were 42% and 74%, significantly higher than 19% and 88% in non-devascularization group (χ2=4.91, 2.56; P 0.05). Conclusions Preoperative devascularization increases the difficulty of liver transplantation for cirrhotic portal hypertension patients and yields high postoperative risk. Nevertheless, gastrointestinal hemorrhage exerts no significant impact upon the efficacy of liver transplantation. Key words: Liver transplantation; Hypertension, portal; Treatment outcome; Pericardial devascularization; Gastrointestinal hemorrhage