Abstract
Background: Cirrhotic patients have higher rates of hypercoagulable disorders. We hypothesized that orthotopic liver transplant (OLT) recipients with pre-operative portal vein thrombosis (PVT) have more post-operative thrombotic events than those without PVT. Aims: To compare rates of post-op thrombotic events and outcomes between those with and without pre-op PVT. Methods: All OLT recipients between 1/02-4/09 were retrospectively reviewed. Outcome measures included survival, deep venous thrombosis, pulmonary embolism, hepatic artery thrombosis, and recurrent PVT. Minimum follow up was 6 months. Results: In 363 OLTs performed, mean recipient age was 53.1 yrs (±9.2); 268 patients were male. Mean MELD at transplant was 22.1 (±6.2). The prevalence of pre-op PVT was 11.2% (41/350). There was no difference in the % of post-op thrombotic events between those with and without PVT (p = 0.77). MELD, recipient and donor age, and gender were similar in both groups. Mean survival in those with pre-op PVT was 85.2 months vs. 78.7 in those without PVT (p = 0.19). Conclusions: The rate of post-op thrombotic events was equivalent in OLT recipients with and without pre-op PVT. The presence of PVT did not adversely impact patient survival and should not be a contraindication to OLT.
Highlights
Portal vein thrombosis is a known complication in those with advanced end stage liver disease (ESLD), occurring in 0.6% - 25% [1,2,3,4] of these patients in contemporary reports
We hypothesized that orthotopic liver transplant (OLT) recipients with pre-operative portal vein thrombosis (PVT) have more postoperative thrombotic events than those without PVT
Mounting evidence suggests that patients with cirrhosis, similar to those with pulmonary embolism or deep venous thrombosis, have underlying inherited or acquired thrombophilic disorders such as prothrombin gene mutation, hyperhomocysteinemia (MTHFR gene mutation), anti-cardiolipin antibodies or Factor V Leiden [4,5, 14,15,16,17]
Summary
Portal vein thrombosis is a known complication in those with advanced end stage liver disease (ESLD), occurring in 0.6% - 25% [1,2,3,4] of these patients in contemporary reports. Hypercoagulability in Liver Transplant Recipients: Does Portal Vein Thrombosis Predict Post-Operative We hypothesized that orthotopic liver transplant (OLT) recipients with pre-operative portal vein thrombosis (PVT) have more postoperative thrombotic events than those without PVT.
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