[Liver transplantation in patients with portal vein thrombosis].
L Janoušek, Miloš Adamec, Martin Oliverius, Pavel Trunečka, M Kučera
Abstract
L Janoušek, Miloš Adamec, Martin Oliverius, Pavel Trunečka, M Kučera
Abstract
BACKGROUND: Portal vein thrombosis has (PVT) long been an absolute contraindication to liver transplantation. In patients scheduled for liver transplantation, portal vein thrombosis occurs in 4-15%. METHODS AND RESULTS: The authors retrospectively collected data on 740 patients who underwent an initial orthotopic liver transplant at the authors' institution between 1996 and 2009. Mean follow-up was from 1 day to 6 years. There were 437 male patients and 303 female patients. We have performed this procedure in 57 recipients with PVT; this constitutes 7.7% of the overall transplant population. There was a 10.5% incidence of liver graft dysfunction, 10.5% of hepatic artery thrombosis, 19.3% of acute rejection and 17.5% of biliary complications. The overall incidence of relaparotomy for bleeding was 28% (16 patients). In-hospital mortality and late mortality were 15.8% and 31.6%, respectively. Volumes transfused were 17.1 (0-425) transfusion units of red blood cell, 27.1 (0-132) of fresh-frozen plasma and 2.6 (0-20) of platelets respectively. CONCLUSIONS: We confirm that PVT is not a contraindication to LTx at the present time.
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BACKGROUND: Portal vein thrombosis has (PVT) long been an absolute contraindication to liver transplantation. In patients scheduled for liver transplantation, portal vein thrombosis occurs in 4-15%. METHODS AND RESULTS: The authors retrospectively collected data on 740 patients who underwent an initial orthotopic liver transplant at the authors' institution between 1996 and 2009. Mean follow-up was from 1 day to 6 years. There were 437 male patients and 303 female patients. We have performed this procedure in 57 recipients with PVT; this constitutes 7.7% of the overall transplant population. There was a 10.5% incidence of liver graft dysfunction, 10.5% of hepatic artery thrombosis, 19.3% of acute rejection and 17.5% of biliary complications. The overall incidence of relaparotomy for bleeding was 28% (16 patients). In-hospital mortality and late mortality were 15.8% and 31.6%, respectively. Volumes transfused were 17.1 (0-425) transfusion units of red blood cell, 27.1 (0-132) of fresh-frozen plasma and 2.6 (0-20) of platelets respectively. CONCLUSIONS: We confirm that PVT is not a contraindication to LTx at the present time.
Key concepts: Contraindication, Medicine, Portal vein thrombosis, Thrombosis, Surgery, Liver transplantation, Incidence (geometry), Transplantation