Portal vein thrombosis in patients undergoing to liver transplantation

José Rivera Romaní, Bertha Cárdenas Ramírez, Omar Mantilla Cruzattí, Wilmer Bacilio Calderon, P. Martin Padilla-Machaca, Carlos Rondón Leyva, José Carlos Chaman Ortiz

Research output: Contribution to journalArticle

Abstract

INTRODUCTION: Portal venous thrombosis (PVT) is common in patients with liver cirrhosis, undergoing liver transplantation (LT); in our setting, this is the first publication with an emphasis on results and surgical strategies. OBJECTIVE: Was to review the case history of the Guillermo Almenara Irigoyen National Hospital, determine characteristics, types of PVT and surgical management. MATERIALS AND METHODS: We analyzed patients undergoing LT who presented PVT between March 2000 and Jun 2018. Of 255 liver transplants in 239 patients, 229 adults and 26 pediatric, these last were excluded. RESULTS: We found 27 patients had PVT (12.2%) diagnosed in pre and during LT, none with malignant PVT, the most frequent etiologies of cirrhosis were non-alcoholic steatohepatitis (37.4%), alcoholic steatohepatitis (22%), autoimmune hepatitis (AIH) (11%), virus B hepatitis (VBH) (7.4%) and others (11.5%). According to PVT grade: Yerdel I in ten patients (37%), Yerdel II in te patients (37%), Yerdel III in four patients (15%) and Yerdel IV in three patients (11%). Surgical strategy used: thrombectomy in 23 cases (85.2%), hemitransposition cavoportal in 2 cases (7.4%), reno-porto anastomosis with interposition of venous graft in 1 case (3.7%) and thrombectomy with interposition of venous graft in 1 case (3.7%). The re - PVT was present in two cases (7.5%). The PVT decreased patient survival after LT 1 year (81.2%), 3 years (78.4%) and 5 years (78.4%) compared with patients without PVT 1 year (84.6%) 3 years (82.3%) and 5 years (82.3%) respectively. CONCLUSIONS: Cirrhosis with PVT was clinically more unbalanced, survival decreased to a higher degree of PVT. Surgical behavior similar to other transplant centers. Early diagnosis is essential to take early surgical action and decrease morbidity and mortality after LT.
Original languageAmerican English
Pages (from-to)258-264
Number of pages7
JournalRevista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru
StatePublished - 1 Jul 2019
Externally publishedYes

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    Rivera Romaní, J., Cárdenas Ramírez, B., Mantilla Cruzattí, O., Bacilio Calderon, W., Padilla-Machaca, P. M., Rondón Leyva, C., & Chaman Ortiz, J. C. (2019). Portal vein thrombosis in patients undergoing to liver transplantation. Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru, 258-264.