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  • Title: Orthotopic liver transplantation in patients with portal vein thrombosis in the absence of hepatocellular carcinoma.
    Author: Fouzas I, Paul A, Becker C, Vernadakis S, Treckmann JW, Máthé Z, Gerken G, Sotiropoulos GC.
    Journal: Transplant Proc; 2012 Nov; 44(9):2734-6. PubMed ID: 23146508.
    Abstract:
    BACKGROUND: Liver transplantation (OLT) in the setting of portal vein thrombosis (PVT) has been a matter of controversy in the past. We herein report our experience with OLT for PVT in the absence of hepatocellular carcinoma. PATIENTS AND METHODS: Data from patients undergoing OLT for end-stage liver disease, having a documented PVT before OLT, were reviewed. RESULTS: Twenty-five patients were included for the period July, 2003 to December, 2009. There were 20 men and 5 women of median age 57 years. Median values for waiting time and Model for End-Stage Liver Disease score were 150 days and 18, respectively. PVT was classified as grade II (n = 6), IIIa (n = 7), IIIb (n = 9), or IVa (n = 3). Partial portal vein resection/reconstruction, operative thrombectomy, and eversion thromboendovenectomy were performed in 2, 16, and 7 instances, respectively. After a median follow-up of 18 months, 14 patients are alive. Survival rates at 3, 6, 9, and 12, months and 3 years post-OLT were 68%, 64%, 61%, 61%, and 61%, respectively. PVT grade was a negative predictor of survival by Cox proportional hazard analysis (P = .0253). CONCLUSION: Despite the technical innovations in recent years, PVT grade correlated with poor patient survival irrespective of the surgical technique.
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