title: Portal hypertension in polycystic liver disease patients does not affect wait-list or immediate post-liver transplantation outcomes.
abstract: OBJECTIVE
  To establish the impact of portal hypertension (PH) on wait-list/post-transplant outcomes in patients with polycystic liver disease (PCLD) listed for liver transplantation.
  
  
  METHODS
  A retrospective single-centre case controlled study of consecutive patients listed for liver transplantation over 12 years was performed from our centre. PH in the PCLD cohort was defined by the one or more of following parameters: (1) presence of radiological or endoscopic documented varices from our own centre or the referral centre; (2) splenomegaly (> 11 cm) on radiology in absence of splenic cysts accounting for increased imaging size; (3) thrombocytopenia (platelets < 150 × 109/L); or (4) ascites without radiological evidence of hepatic venous outflow obstruction from a single cyst.
  
  
  RESULTS
  Forty-seven PCLD patients (F: M = 42: 5) were listed for liver transplantation (LT) (single organ,n= 35; combined liver-kidney transplantation,n= 12) with 19 patients (40.4%) having PH. When comparing the PH group with non-PH group, the mean listing age (PH group, 50.6 (6.4); non-PH group, 47.1 (7.4) years;P= 0.101), median listing MELD (PH group, 12; non-PH group, 11;P= 0.422) median listing UKELD score (PH group, 48; non-PH group, 46;P= 0.344) and need for renal replacement therapy (P= 0.317) were similar. In the patients who underwent LT alone, there was no difference in the duration of ICU stay (PH, 3 d; non-PH, 2 d;P= 0.188), hospital stay length (PH, 9 d; non-PH, 10 d;P= 0.973), or frequency of renal replacement therapy (PH, 2/8; non-PH, 1/14;P= 0.121) in the immediate post-transplantation period.
  
  
  CONCLUSIONS
  Clinically apparent portal hypertension in patients with PCLD listed for liver transplantation does not appear to have a major impact on wait-list or peri-transplant morbidity.
authors.affiliation: Neil Rajoriya, Dhiraj Tripathi, Joanna A Leithead, Bridget K Gunson, Sophie Lord, James W Ferguson, Gideon M Hirschfield, Liver Unit, Queen Elizabeth Hospital, Birmingham B152WB, United Kingdom.
authors.forename: Neil
authors.initials: N
authors.lastname: Rajoriya
authors.affiliation: Neil Rajoriya, Dhiraj Tripathi, Joanna A Leithead, Bridget K Gunson, Sophie Lord, James W Ferguson, Gideon M Hirschfield, Liver Unit, Queen Elizabeth Hospital, Birmingham B152WB, United Kingdom.
authors.forename: Dhiraj
authors.initials: D
authors.lastname: Tripathi
authors.affiliation: Neil Rajoriya, Dhiraj Tripathi, Joanna A Leithead, Bridget K Gunson, Sophie Lord, James W Ferguson, Gideon M Hirschfield, Liver Unit, Queen Elizabeth Hospital, Birmingham B152WB, United Kingdom.
authors.forename: Joanna A
authors.initials: JA
authors.lastname: Leithead
authors.affiliation: Neil Rajoriya, Dhiraj Tripathi, Joanna A Leithead, Bridget K Gunson, Sophie Lord, James W Ferguson, Gideon M Hirschfield, Liver Unit, Queen Elizabeth Hospital, Birmingham B152WB, United Kingdom.
authors.forename: Bridget K
authors.initials: BK
authors.lastname: Gunson
authors.affiliation: Neil Rajoriya, Dhiraj Tripathi, Joanna A Leithead, Bridget K Gunson, Sophie Lord, James W Ferguson, Gideon M Hirschfield, Liver Unit, Queen Elizabeth Hospital, Birmingham B152WB, United Kingdom.
authors.forename: Sophie
authors.initials: S
authors.lastname: Lord
authors.affiliation: Neil Rajoriya, Dhiraj Tripathi, Joanna A Leithead, Bridget K Gunson, Sophie Lord, James W Ferguson, Gideon M Hirschfield, Liver Unit, Queen Elizabeth Hospital, Birmingham B152WB, United Kingdom.
authors.forename: James W
authors.initials: JW
authors.lastname: Ferguson
authors.affiliation: Neil Rajoriya, Dhiraj Tripathi, Joanna A Leithead, Bridget K Gunson, Sophie Lord, James W Ferguson, Gideon M Hirschfield, Liver Unit, Queen Elizabeth Hospital, Birmingham B152WB, United Kingdom.
authors.forename: Gideon M
authors.initials: GM
authors.lastname: Hirschfield
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003560:Cysts / Q000150:complications / Q000601:surgery*; D058625:End Stage Liver Disease / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications*; D007362:Intensive Care Units; D007676:Kidney Failure, Chronic / Q000150:complications / Q000601:surgery; D007902:Length of Stay; D008107:Liver Diseases / Q000150:complications / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014850:Waiting Lists
keywords: Liver transplantation; Polycystic liver disease; Portal hypertension