Comparative analysis of the results of orthotopic liver transplantation in patients with and without portal vein thrombosis.
BACKGROUND
Portal vein thrombosis (PVT), which had been considered an absolute contraindication to orthotopic liver transplantation (OLT), is currently considered a risk factor that increases morbi-mortality. The objective of this study was to compare OLT outcomes in patients with vs without PVT.


METHODS
Between April 1986 and December 2003, a sample of 83 patients with PVT was compared with another sample of 83 patients without PVT among 962 OLT performed in our department.


RESULTS
Both groups were homogeneous in terms of epidemiological variables, surgical technique, immunosuppression, and donor-related variables. There were no differences with respect to graft function during the first week following surgery. Surgical time and anhepatic phase duration was longer in the PVT group, albeit the differences were not significant. PVT patients also required more transfusions; a strong statistical association was observed with respect to blood (P = .12) and plasma (P = .11) transfusions and statistically significant differences regarding platelet transfusions (P = .02). Time on mechanical ventilation and the length of stay in the ICU were longer but not significant among PVT patients. The only statistically significant difference was the incidence of portal rethrombosis (P = .02). With respect to mean and global patient and graft actuarial survivals after 1, 3, 5, and 10 years, we have observed no significant intergroup differences, although both patient (P = .48; NS) and graft (P = .96, NS) survivals were lower among PVT cases.


CONCLUSIONS
PVT should not only cease to be considered a contraindication for OLT, but there were no significant differences between the outcomes despite this finding.
Gimeno
F A
FA
Servicio de Cirugía General, Aparato Digestivo y Trasplante de Organos Abdominales (Prof. E. Moreno González), Hospital Universitario 12 de Octubre, Madrid, Spain.
Calvo
J
J
Loinaz
C
C
Meneu
J C
JC
Pérez
B
B
Gomez
R
R
Jiménez
C
C
Abradelo
M
M
Moreno
A
A
Sesma
A
A
García
I
I
Moreno
E
E
D000293:Adolescent; D000328:Adult; D001201:Ascites / Q000150:complications; D005500:Follow-Up Studies; D006085:Graft Survival / Q000502:physiology; D006501:Hepatic Encephalopathy / Q000601:surgery; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality / Q000502:physiology; D011169:Portal Vein; D012189:Retrospective Studies; D013152:Splanchnic Circulation; D016019:Survival Analysis; D013927:Thrombosis / Q000150:complications*; D013997:Time Factors; D016896:Treatment Outcome; D014648:Varicose Veins / Q000601:surgery