Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2018
Outcomes of Living Donor Liver Transplantation for Patients with Preoperative Portal Vein Problems.
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Wahab Mohamed Abdel, Shehta Ahmed, Elshoubary Mohamed, Salah Tarek, Fathy Omar, Sultan Ahmed, Elghawalby Ahmed Nabieh, Ali Mahmoud, Yassen Amr Mohamed, Elmorshedi Mohamed, Eldesoky Mohamed, Monier Ahmed, Said Rami
Аннотация
BACKGROUND: Portal vein thrombosis (PVT) is a common complication for patients with end-stage liver disease. The presence of PVT used to be a contraindication to living donor liver transplantation (LDLT). The aim of this study is to evaluate the influence of preoperative PVT on perioperative and long-term outcomes of the recipients after LDLT.
METHODS: We reviewed the data of patients who underwent LDLT during the period between 2004 till 2017.
RESULTS: During the study period, 500 cases underwent LDLT. Patients were divided into three groups. Group I included non-PVT, 446 patients (89.2%); group II included attenuated PV, 26 patients (5.2%); and group III included PVT, 28 patients (5.6%). Higher incidence of hematemesis and encephalopathy was detected in PVT (p = 0.001). Longer anhepatic phase was found in PVT (p = 0.013). There were no significant differences between regarding operation time, blood loss, transfusion requirements, ICU, and hospital stay. The 1-, 3-, and 5-year overall survival (OS) rates of non-PVT were 80.5%, 77.7%, and 75%, and for attenuated PV were 84.6%, 79.6%, and 73.5%, and for PVT were 88.3%, 64.4%, and 64.4%, respectively. There was no significant difference between the groups regarding OS rates (logrank 0.793).
CONCLUSION: Preoperative PVT increases the complexity of LDLT operation, but it does not reduce the OS rates of such patients.
METHODS: We reviewed the data of patients who underwent LDLT during the period between 2004 till 2017.
RESULTS: During the study period, 500 cases underwent LDLT. Patients were divided into three groups. Group I included non-PVT, 446 patients (89.2%); group II included attenuated PV, 26 patients (5.2%); and group III included PVT, 28 patients (5.6%). Higher incidence of hematemesis and encephalopathy was detected in PVT (p = 0.001). Longer anhepatic phase was found in PVT (p = 0.013). There were no significant differences between regarding operation time, blood loss, transfusion requirements, ICU, and hospital stay. The 1-, 3-, and 5-year overall survival (OS) rates of non-PVT were 80.5%, 77.7%, and 75%, and for attenuated PV were 84.6%, 79.6%, and 73.5%, and for PVT were 88.3%, 64.4%, and 64.4%, respectively. There was no significant difference between the groups regarding OS rates (logrank 0.793).
CONCLUSION: Preoperative PVT increases the complexity of LDLT operation, but it does not reduce the OS rates of such patients.