Abstract
BackgroundPortal vein thrombosis is a frequent complication in end-stage cirrhosis with a considerable peri-operative risk for liver transplant candidates. We aimed to characterize the pre-transplant portal vein thrombosis in a cohort of liver transplant recipients, and to identify independent risk factors for this complication.Methods380 consecutive primary orthotopic liver transplants were performed in the Digestive Surgery Department of “12 de Octubre” Hospital (Madrid, Spain), between January 2001 and December 2006. The main risk factors considered were smoking, obesity, metabolic disorders, previous immobility, surgery or trauma, nephrotic syndrome, associated tumor, inflammatory disease, neoplasm myeloprolipherative. Furthermore we have reported genetic thrombophilia results for 271 recipients.ResultsSixty-two (16.3%) patients developed pre-transplant portal vein thrombosis and its presence had no impact in the overall survival of liver recipients. Obesity was the only independent risk factor for pre-transplant portal vein thrombosis.ConclusionWe recommend close control of cardiovascular factors in patients with liver cirrhosis in order to avoid associated thrombosis.
Highlights
Portal vein thrombosis is a frequent complication in end-stage cirrhosis with a considerable peri-operative risk for liver transplant candidates
Portal vein thrombosis (PVT) may result from a thrombophilic condition such as myeloproliferative disease, Protein C (PC), Protein S (PS) and Antithrombin (AT) deficiency, or Factor V Leiden and Factor IIG20210A carriers, or a combination of a primary thrombophilia milieu that triggers the formation of the thrombus in the portal circulation [2]
We aimed to identify possible parameters that could lead to PVT in a cohort of liver transplant recipients
Summary
Portal vein thrombosis is a frequent complication in end-stage cirrhosis with a considerable peri-operative risk for liver transplant candidates. We aimed to characterize the pre-transplant portal vein thrombosis in a cohort of liver transplant recipients, and to identify independent risk factors for this complication. Portal vein thrombosis (PVT) is a well recognized complication in patients with end-stage cirrhosis, and its incidence ranges from 2 to 26% in different series [1]. The cause may be local, such as cirrhosis, primary or metastatic liver cancer, pylephlebitis, vascular abnormalities, and pancreatitis. PVT continues to be associated with a considerable peri-operative risk for liver transplant candidates [3,4], and is associated with increased operative time, transfusion requirements, re-interventions, and lower survival rate relative to PVT extension [5]. PVT has been seen as an obstacle to orthotopic liver transplantation (OLT)
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