Liver transplantation in adults with portal vein thrombosis: Data from the China Liver Transplant Registry.
OBJECTIVE
Portal vein thrombosis (PVT) is a common complication in patients with liver cirrhosis. During liver transplantation (LT), PVT may complicate the procedure and lead to a poor prognosis. The aim of this study is to evaluate patients enrolled in the China Liver Transplant Registry, to understand the influence of PVT to the LT recipients.


METHODS
We collected data from patients who underwent LT and were entered into the China Liver Transplant Registry. All data of medical records and follow-up were retrospectively reviewed. The preoperative condition, duration of surgery, intraoperative blood loss, postoperative early and late PVT, and survival rates were compared between patients with PVT and those without PVT. Multivariate Cox analysis and survival analysis were used to determine the influence of PVT.


RESULTS
A total of 20,524 cases were recruited into the study. In all, 1810 (8.82%) patients were diagnosed with preoperative PVT of various severities. All patients were followed up for an average of 30.25±33.25months (up to a maximum of 171.68months). Patients with PVT had a significantly longer operating time, more intraoperative blood loss and a higher rate of post-LT PVT (P<0.001). Multivariate Cox analysis showed that PVT did not reduce the recipients' survival rate (HR=0.89, 95% CI: 0.774-1.024, P=0.103). There was no significant difference in cumulative survival rate (P=0.059) between patients without PVT, and patients with PVT.


CONCLUSIONS
PVT increases the difficulty of LT, but doesn't reduce the survival rate. Therefore, PVT is not an absolute contraindication for LT in experienced transplantation centers.
Department of hepatobiliary surgery, Peking University People's Hospital, Beijing 100044, China. Electronic address: sunshinegaopj@sina.com.
Peng Ji
PJ
Gao
Department of hepatobiliary surgery, Peking University People's Hospital, Beijing 100044, China. Electronic address: gaojie2@medmail.com.
Jie
J
Gao
Department of hepatobiliary surgery, Peking University People's Hospital, Beijing 100044, China. Electronic address: goodlizhao@sina.com.
Zhao
Z
Li
Department of hepatobiliary surgery, Peking University People's Hospital, Beijing 100044, China. Electronic address: hzp0325@126.com.
Zhi Ping
ZP
Hu
Department of hepatobiliary surgery, Peking University People's Hospital, Beijing 100044, China. Electronic address: lengxsh@163.com.
Xi Sheng
XS
Leng
Department of hepatobiliary surgery, Peking University People's Hospital, Beijing 100044, China. Electronic address: gandanwk@vip.sina.com.
Ji Ye
JY
Zhu
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D002681:China; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011169:Portal Vein; D012042:Registries; D012189:Retrospective Studies; D020246:Venous Thrombosis / Q000209:etiology*; D055815:Young Adult