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Thrombosis confined to the portal vein is not a contraindication for living donor liver transplantation

Cited 25 time in Web of Science Cited 24 time in Scopus
Authors
Cho, Jai Young; Suh, Kyung-Suk; Shin, Woo Young; Lee, Hae Won; Yi, Nam-Joon; Lee, Kuhn Uk
Issue Date
2008-06-11
Publisher
Springer Verlag
Citation
World J Surg. 2008 ;32(8):1731-7.
Keywords
FemaleGraft SurvivalHumansLiver Transplantation/contraindications/*methods*Living DonorsLogistic ModelsMaleMiddle AgedPortal VeinProspective StudiesRisk FactorsStatistics, NonparametricSurvival RateThrombectomyTomography, X-Ray ComputedTreatment OutcomeUltrasonography, DopplerVenous Thrombosis/*complications/radiography/surgery/ultrasonography
Abstract
BACKGROUND: There is a lack of agreement regarding preexisting portal vein thrombosis (PVT) in patients undergoing living donor liver transplantation (LDLT). We report the results of a single-center study to determine the impact of PVT on outcomes of adult LDLT recipients. METHODS: Of 133 cases of adult LDLT performed between January 2000 and December 2004, a thrombectomy was performed on 22 patients (16.5%) with PVT during the transplant procedure. One hundred eleven patients without PVT (group 1) were compared with those with a thrombosis confined to the portal vein (group 2; n = 15) and patients with the thrombosis beyond the portal vein (group 3; n = 7). RESULTS: The sensitivities of Doppler ultrasound and CT in detecting PVT were 50 and 63.6%. A prior history of variceal bleeding (OR = 10.6, p = 0.002) and surgical shunt surgery (OR = 28.1, p = 0.044) were found to be an independent risk factors for PVT. The rate of postoperative PVT was significantly higher in patients with PVT than in those without (18.2 vs. 2.7%; p = 0.014). In particular, the rethrombosis rate in group 3 was 28.6%. The actuarial 3-year patient survival rate in PVT patients (73.6%) was similar to that of the non-PVT patients (85.3%; p = 0.351). However, the actuarial 3-year patient survival rate in group 3 was 38.1%, which was significantly lower than that in groups 1 and 2 (p = 0.006). CONCLUSION: A thrombosis confined to the portal vein per se should not be considered a contraindication for LDLT.
ISSN
0364-2313 (Print)
Language
English
URI
http://hdl.handle.net/10371/62450
DOI
https://doi.org/10.1007/s00268-008-9651-4
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College of Medicine/School of Medicine (의과대학/대학원)Surgery (외과학전공)Journal Papers (저널논문_외과학전공)
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