title: Nontumoral portal vein thrombosis in patients awaiting liver transplantation.
abstract: Portal vein thrombosis (PVT) occurs in approximately 2%-26% of the patients awaiting liver transplantation (LT) and is no longer an absolute contraindication for LT. Nearly half of PVT cases are accidentally found during the LT procedure. The most important risk factor for PVT development in cirrhosis may be the severity of liver disease and reduced portal blood flow. Whether other inherited or acquired coagulation disorders also play a role is not yet clear. The development of PVT may have no effect on the liver disease progression, especially when it is nonocclusive. PVT may not increase the risk of wait-list mortality, but it is a risk factor for poor early post-LT mortality. Anticoagulation and transjugular intrahepatic portosystemic shunt (TIPS) are 2 major treatment strategies for patients with PVT on the waiting list. The complete recanalization rate after anticoagulation is approximately 40%. The role of TIPS to maintain PV patency for LT as the primary indication has been reported, but the safety and efficacy should be further evaluated. PVT extension and degree may determine the surgical technique to be used during LT. If a "conventional" end-to-end portal anastomotic technique is used, there is not a major impact on post-LT survival. Post-LT PVT can significantly reduce both graft and patient survival after LT and can preclude future options for re-LT.
authors.affiliation: Barcelona Hepatic Hemodynamic Laboratory, Liver Unit, Barcelona, Spain.
authors.forename: Hui
authors.initials: H
authors.lastname: Chen
authors.affiliation: Barcelona Hepatic Hemodynamic Laboratory, Liver Unit, Barcelona, Spain.|Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Madrid, Spain.
authors.forename: Fanny
authors.initials: F
authors.lastname: Turon
authors.affiliation: Barcelona Hepatic Hemodynamic Laboratory, Liver Unit, Barcelona, Spain.|Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Madrid, Spain.
authors.forename: Virginia
authors.initials: V
authors.lastname: Hernández-Gea
authors.affiliation: HBP Surgery and Liver Transplantation Unit, University of Barcelona, Barcelona, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Fuster
authors.affiliation: Department of Radiology, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.
authors.forename: Angeles
authors.initials: A
authors.lastname: Garcia-Criado
authors.affiliation: Department of Radiology, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Barrufet
authors.affiliation: Department of Radiology, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.
authors.forename: Anna
authors.initials: A
authors.lastname: Darnell
authors.affiliation: HBP Surgery and Liver Transplantation Unit, University of Barcelona, Barcelona, Spain.
authors.forename: Constantino
authors.initials: C
authors.lastname: Fondevila
authors.affiliation: HBP Surgery and Liver Transplantation Unit, University of Barcelona, Barcelona, Spain.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Garcia-Valdecasas
authors.affiliation: Barcelona Hepatic Hemodynamic Laboratory, Liver Unit, Barcelona, Spain.|Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Madrid, Spain.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Garcia-Pagán
mesh_terms: D000925:Anticoagulants; D006085:Graft Survival; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D011169:Portal Vein / Q000503:physiopathology; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D014850:Waiting Lists / Q000401:mortality
chemical_list: D000925:Anticoagulants