Surgery today · 2026
Characteristics and treatment outcomes of portal hypertension after living donor liver transplantation.
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Mita Atsuyoshi, Ohno Yasunari, Masuda Yuichi, Kubota Koji, Notake Tsuyoshi, Shimizu Akira, Soejima Yuji
Аннотация
PURPOSE: Portal hypertension (PoH) after liver transplantation is a severe complication that results in graft loss. We investigated the characteristics and evaluated the treatment outcomes of PoH after living donor liver transplantation (LDLT).
METHODS: This single-center, retrospective cohort study included 325 LDLT recipients.
RESULTS: Of the subjects, 37 (11.4%) had a PoH. The 10- and 20-year graft survival rates were significantly lower in patients with PoH than in those without PoH (69.1% vs. 90.8% and 42.1% vs. 84.7%, respectively; p < 0.0001). The types of PoH were pre-hepatic, hepatic, and post-hepatic in 16, 13, and 8 patients, respectively. Interventional radiology was performed for PoH in all post-hepatic PoH patients and in 62.5% of pre-hepatic PoH patients. Notably, 46.2% of the patients with hepatic PoH required re-transplantation. The 10-year graft survival rate was significantly worse in patients with hepatic PoH than in those with pre- and post-hepatic PoH (46.2% vs. 86.7% and 75.0%, respectively; P < 0.05). Post-transplant PoH was an independent predictor of graft loss after LDLT (hazard ratio, 5.73; 95% confidence interval: 2.43-13.55, P < 0.0005).
CONCLUSIONS: Post-transplant PoH negatively affected the graft survival in LDLT recipients. Pre-hepatic, hepatic, and post-hepatic PoH cases had different characteristics, requiring different treatments. Therefore, an appropriate diagnosis and treatment are important.
METHODS: This single-center, retrospective cohort study included 325 LDLT recipients.
RESULTS: Of the subjects, 37 (11.4%) had a PoH. The 10- and 20-year graft survival rates were significantly lower in patients with PoH than in those without PoH (69.1% vs. 90.8% and 42.1% vs. 84.7%, respectively; p < 0.0001). The types of PoH were pre-hepatic, hepatic, and post-hepatic in 16, 13, and 8 patients, respectively. Interventional radiology was performed for PoH in all post-hepatic PoH patients and in 62.5% of pre-hepatic PoH patients. Notably, 46.2% of the patients with hepatic PoH required re-transplantation. The 10-year graft survival rate was significantly worse in patients with hepatic PoH than in those with pre- and post-hepatic PoH (46.2% vs. 86.7% and 75.0%, respectively; P < 0.05). Post-transplant PoH was an independent predictor of graft loss after LDLT (hazard ratio, 5.73; 95% confidence interval: 2.43-13.55, P < 0.0005).
CONCLUSIONS: Post-transplant PoH negatively affected the graft survival in LDLT recipients. Pre-hepatic, hepatic, and post-hepatic PoH cases had different characteristics, requiring different treatments. Therefore, an appropriate diagnosis and treatment are important.