부산대학교 도서관

INTRODUCTION: Portal vein thrombosis is a late consequence of advanced cirrhosis. Its development has been associated with worse long term patient and graft survival, as well as a higher risk of vascular complications after liver transplantation. MATERIAL AND METHODS: We reviewed all patients over 18 years old who underwent liver transplantation (LT) at University Hospital “12 de Octubre” between January 2002 and January 2017. Pediatric recipients and cases of retransplantation were excluded. Patients were divided according to the presence of preoperative portal thrombosis (PT, 126 patients) or no PT (N-PT, 724 patients). RESULTS: Mean recipient age was 55.5±9 in PT vs 53.7±11 in N-PT (p 0.085), with a similar number of male patients in both groups (76.2% en PT vs 72.8% in N-PT; p 0.431). There was a 59,2% rate of HCV infection in the PT group (52.4% in N-PT; p 0.157), and 22.2% of patients in the same group had a diagnosis of hepatocellular carcinoma (vs 29,9% in N-PT group; p 0.080).Mean preoperative MELD score was 14.7 en TP vs 15.6 in N-PT (p 0.067). There were no significant differences found regarding preoperative BMI, haemoglobin, MELD-Na score and Child-Pugh score.16.7 % of patients in the PT group received a subobtimal graft for LT, vs 21.7% in the N-PT group (p 0.204).In relation to blood products transfusion, an average of 12.3 units of RBC was administered in the the PT group and 9.2 in the N-PT (p 0.084), with an average of 14.6 and 12.8 FFP units respectively (p 0.093) and no differences found when reviewing platelets and fibrinogen.Mean ICU stay was 9.2 days in PT vs 6.7 in N-PT (p 0.075), while mean ward stay was 17.7 days in PT vs 19.4 in N-PT (p 0.429).Portal thrombosis recurrence rate was 4% in patients with a previous diagnosis of PT, significantly higher than in those without said previous history (1.1% in N-PT; p 0.015). However, the rate of arterial thrombosis was 4.8% in the PT group vs 3.8% in the N-PT group with no statistical significance (p 0.890). Retransplantation rate was 4% in PT and 6.2% in N-PT (p 0.326).Actuarial survival at 1, 3 and 5 years was 86.5%, 79.1% and 76.2% respectively in the PT group, vs 84.5%, 78.3% y 74.3% in the N-PT group (p=0.489). CONCLUSION: Pretransplant portal thrombosis is a diagnosis that has not been associated with a decreased survival after LT in our series; but seems to determine an increase in transfusion requirements and a higher risk of postoperative vascular complications.