Survival among children with portal vein thrombosis and end-stage liver disease.
Occlusive PVT concurrent with chronic liver disease is a common clinical entity among pediatric patients referred for transplantation. The natural history of PVT is unknown. Our aim was to determine, using a retrospective cohort design, if children under 13 yr with chronic liver disease and concomitant PVT have an increased mortality risk prior to and after transplantation. A total of 203 patients were included in the study. Nearly 10% of the population had PVT (n = 19); 63.2% of PVT patients (5.9% of total cohort) underwent liver transplantation (n = 12). PVT patients tended to be younger than non-PVT patients at evaluation (1.94 +/- 3.51 vs. 3.79 +/- 4.11, p = 0.059). Clinical and demographic factors were similar between the two groups. Regarding survival, four PVT patients died, of which two had undergone transplantation. Kaplan-Meier analyses indicated that PVT and non-PVT patients had similar survival from the time of evaluation, on the waiting list, and after transplant. Although limited by sample size, our study suggests that a diagnosis of PVT does not increase the mortality risk for children waiting for a liver transplant. Further study is needed to discern variations in mortality risk that may occur in the pediatric chronic liver disease population with PVT.
Division of Transplantation, Department of Surgery, University of Michigan, Ann Arbor, MI 48109-0331, USA.
Shaza
S
Al-Holou
Amit K
AK
Mathur
David
D
Ranney
James
J
Kubus
Michael J
MJ
Englesbe
D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000401:mortality* / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D011169:Portal Vein; D011184:Postoperative Period; D057234:Preoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D014481:United States / Q000453:epidemiology; D020246:Venous Thrombosis / Q000150:complications / Q000401:mortality* / Q000601:surgery