title: Clinical Impact of Portal Vein Thrombosis Prior to Liver Transplantation: A Retrospective Cohort Study.
abstract: To identify the impact of portal vein thrombosis (PVT) and associated medical and surgical factors on outcomes post liver transplant (LT).
  
  
  
  Two analyses were performed. Analysis One: cohort study of 505 consecutive patients who underwent LT (Alberta) between 01/2002-12/2012. PVT was identified in 61 (14%) patients. Analysis Two: cohort study of 144 consecutive PVT patients from two sites (Alberta and London) during the same period. Cox multivariable survival analysis was used to identify independent associations with post-LT mortality.
  
  
  
  In Analysis One (Alberta), PVT was not associated with post-LT mortality (log rank p = 0.99). On adjusted analysis, complete/occlusive PVT was associated with increased mortality (Hazard Ratio (HR) 8.4, p &amp;lt; 0.001). In Analysis Two (Alberta and London), complete/occlusive PVT was associated with increased mortality only on unadjusted analysis (HR 3.7, p = 0.02). On adjusted analysis, Hepatitis C (HR 2.1, p = 0.03) and post-LT portal vein re-occlusion (HR 3.2, p = 0.01) were independently associated with increased mortality.
  
  
  
  Well-selected LT patients who had PVT prior to LT had similar post-LT outcomes to non-PVT LT recipients. Subgroups of PVT patients who did worse post-LT (complete/occlusive thrombosis pre-LT, Hepatitis C or post-LT portal vein re-occlusion) warrant closer evaluation in listing and management post-LT.
authors.affiliation: Division of Gastroenterology (Liver Unit), University of Alberta, Edmonton, Canada.
authors.forename: Constantine J
authors.initials: CJ
authors.lastname: Karvellas
authors.affiliation: Division of Critical Care Medicine, University of Alberta, Edmonton, Canada.
authors.forename: Filipe S
authors.initials: FS
authors.lastname: Cardoso
authors.affiliation: Division of Gastroenterology, Department of Surgical and Gastroenterological Sciences, University Hospital of Padova, Padova, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Senzolo
authors.affiliation: Division of Gastroenterology (Liver Unit), London Health Sciences Centre, Western University, London, Canada.
authors.forename: Malcolm
authors.initials: M
authors.lastname: Wells
authors.affiliation: Division of Gastroenterology (Liver Unit), London Health Sciences Centre, Western University, London, Canada.
authors.forename: Mansour G
authors.initials: MG
authors.lastname: Alghanem
authors.affiliation: Division of Gastroenterology (Liver Unit), University of Alberta, Edmonton, Canada.
authors.forename: Fayaz
authors.initials: F
authors.lastname: Handou
authors.affiliation: Division of Gastroenterology (Liver Unit), London Health Sciences Centre, Western University, London, Canada.
authors.forename: Lukasz
authors.initials: L
authors.lastname: Kwapisz
authors.affiliation: Division of Surgery (Transplantation), University of Alberta, Edmonton, Canada.
authors.forename: Norman M
authors.initials: NM
authors.lastname: Kneteman
authors.affiliation: Division of Surgery (Transplantation), University of Alberta, Edmonton, Canada.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Marotta
authors.affiliation: Division of Surgery (Transplantation), University of Alberta, Edmonton, Canada.
authors.forename: Bandar
authors.initials: B
authors.lastname: Al-Judaibi
mesh_terms: D002170:Canada; D016009:Chi-Square Distribution; D058625:End Stage Liver Disease / Q000175:diagnosis / Q000401:mortality / Q000601:surgery* / Q000821:virology; D005260:Female; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000401:mortality / Q000601:surgery* / Q000821:virology; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011169:Portal Vein / Q000000981:diagnostic imaging; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery
keywords: Liver Transplantation; anticoagulation; cirrhosis; portal vein thrombosis