Year 2016 / Volume 108 / Number 11
Original
Prevalence and outcome of portal thrombosis in a cohort of cirrhotic patients undergoing liver transplantation

716-720

DOI: 10.17235/reed.2016.4211/2016

Marta Hernández Conde, Elba Llop Herrera, Juan de la Revilla Negro, Fernando Pons Renedo, Natalia Fernández Puga, José Luis Martínez Porras, María Trapero Marugan, Valentín Cuervas-Mons, Víctor Sánchez Turrión, José Luis Calleja Panero,

Abstract
Introduction: The prevalence of portal vein thrombosis (PVT) in patients that have undergone liver transplantation (LT) is 9.7% (SD 4.5). The aim of our study was to determine the prevalence, assess the factors that are associated with PVT and clarify their association with prognosis in patients with liver cirrhosis (LC) and LT. Aims and methods: From 2005 to 2014, laboratory, radiological and surgical data were collected from patients with LC in our center who had undergone LT for the first time. Results: One hundred and ninety-one patients were included. The mean age was 55 (SD 9), 75.4% of patients were male and 48.7% had HCV. The Child-Pugh scores were A/B/C 41.9%/35.9%/25.5% and the MELD score was 15 (SD 6). Previous decompensations were: ascites (61.4%), hepatic encephalopathy (34.4%), variceal bleeding (25.4%), hepatocellular carcinoma (48.9%) and spontaneous bacterial peritonitis (SPB) (14.3%). The mean post-transplant follow-up was 42 months (0-113). PVT was diagnosed at LT in 18 patients (9.4%). Six patients were previously diagnosed using imaging tests (33.3%): 2 patients (11.1%) by DU and 4 patients (22.2%) by CT scan. All patients with PVT had DU in a mean time of 6 months before LT (0-44) and 90 patients (47.1%) had a CT scan in a median time of 6 months before LT (0-45). PVT was significantly related to the presence of SBP (33.3% vs 12.6%; p = 0.02) and lower levels of albumin (3.1g/dl vs 3.4g/dl; p = 0.05). MELD was higher in patients with PVT (16.6 vs 14.9; p = 0.3). There were no significant differences with regard to the need for transfusion of blood components. Moreover, the surgery time was similar in both groups. PVT correlated with a higher mortality in the first 30 days (8.8% vs 16.7%; p = 0.2). Conclusion: Prior history of SBP and lower levels of albumin were identified as factors associated with PVT. The pre-transplant diagnosis rate is very low and the presence of PVT may have implications for short-term mortality.
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Comments

20/12/2016 12:52:14
Excelente trabajo. ¡Enhorabuena!


References
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Hernández Conde M, Llop Herrera E, de la Revilla Negro J, Pons Renedo F, Fernández Puga N, Martínez Porras J, et all. Prevalence and outcome of portal thrombosis in a cohort of cirrhotic patients undergoing liver transplantation. 4211/2016


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Publication history

Received: 19/01/2016

Accepted: 05/09/2016

Online First: 19/10/2016

Published: 02/11/2016

Article revision time: 227 days

Article Online First time: 274 days

Article editing time: 288 days


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