Impact of portal vein thrombosis in outcomes of liver transplantation according to Yerdel’S grade

Abstract

Aims: To analyze the incidence of PVT in candidates to OLT in our center, as well as to compare morbidity and mortality among those affected by this complication according to Yerdel´s grade and those who are free of it. Methods: Prospective comparative study in candidates undergone to OLT with PVT and control group without this complication in 653 recipients from January 2002 to December 2013. Age, gender, MELD, indication of transplant, type of thrombosis, surgical technique, red blood cell transfusion, GPT peak andl one year overall survival were analyzed. Results: 87 patients presented PVT (13.3%) among the 653 candidates transplanted. Regarding the type of thrombosis, 72.2% were partial and 26.2% were complete. The surgical technique used in 77% of the candidates with PVT were thrombectomy. Significant differences were observed in the consumption of red blood cell concentrates between the group with PVT versus no PVT (p = 0.001). Postoperative portal vein thrombosis was higher in PVT group when we compare with non-PVT group (p = 0.046). No significant differences were found in the GPT peak. We have found worse survival, although not statistically significant, in patients with PVT Yerdel grade 2-3-4 when we compared with grade 1 or non PVT patients. Conclusions: Patients with Yerdel grade 1 PVT have survival similar to those without PVT. Cases with PVT grades 2, 3, 4 tend to have a lower survival rate. The preoperative PVT is a risk factor for post-transplant PVT, as a result of lower portal flow obtained after reperfusion in these patients.