[Is surgery for portal hypertension a contraindication for liver transplantation?].
BACKGROUND
Orthotopic liver transplantation (OLT) is the only curative treatment for hepatic cirrhosis and is the most effective in the control of portal hypertension. The aim of this study was to analyze whether greater morbi-mortality is observed in patients undergoing liver transplantation with previous surgery for portal hypertension with respect to patients not having undergone this surgery.


METHODS
Different variables were analyzed in 2 groups of transplanted patients: one of 18 patients who had previously undergone surgery for portal hypertension and another group of 54 patients without this previous surgery.


RESULTS
The following factors were studied: mean operative time and length of anahepatic phase, intraoperative consumption of concentrates of erythrocytes, fresh frozen plasma, units of platelets and cryoprecipitates, days of mechanical ventilation, stay in the ICU and total postoperative stay. No significant differences were observed (p < 0.05) in any of these factors or in survival.


CONCLUSIONS
On analysis of the difficulty of surgical technique, postoperative evolution and survival and based on the variables described it may be concluded that previous surgery for portal hypertension does not only not contraindicate posterior liver transplantation, but rather may be useful in patients with an adequate hepative reserve presenting variceal hemorrhage since posterior transplantation does not present a worsened prognosis.
Poves
I
I
Unidad de Trasplante Hepático, Ciutat Sanitària i Universitària de Bellvitge, Hospital Prínceps d'Espanya, Barcelona.
Figueras
J
J
Lama
C
C
Fabregat
J
J
Rafecas
A
A
Torras
J
J
Ramos
E
E
Ruiz
D
D
Casanovas
T
T
Xiol
X
X
Baliellas
C
C
Jaurrieta
E
E
D000328:Adult; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000601:surgery*; D007430:Intraoperative Care; D007902:Length of Stay; D008103:Liver Cirrhosis / Q000150:complications / Q000628:therapy; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011379:Prognosis
Representa la cirugía de la hipertensión portal una contraindicación al trasplante hepático?