Department of Tropical Medicine, Ain Shams Center for Organ Transplantation (ASCOT), Ain Shams University, Cairo, Egypt.
Department of Tropical Medicine, Ain Shams Center for Organ Transplantation (ASCOT), Ain Shams University, Cairo, Egypt.
Arab J Gastroenterol. 2022 Aug;23(3):159-164. doi: 10.1016/j.ajg.2022.03.002. Epub 2022 Jun 7.
Portal vein thrombosis (PVT) is no longer an absolute contraindication for living donor liver transplantation (LDLT). This study aimed to assess the short-term outcomes of LDLT and compare the 1-year survival rates between patients with and without preoperative PVT.
This combined prospective and retrospective cohort study was conducted on patients who underwent LDLT at Ain Shams Centre for Organ Transplantation (ASCOT) between 2008 and 2020. The study included 60 patients with PVT and 60 patients without PVT. The two groups were compared in terms of preoperative data, operative details, postoperative complications, and 1-year survival.
Most patients with PVT were Child C (65%) and had higher model for end stage liver disease scores (16.23 ± 4.03) compared to the non-PVT group (13.9 ± 4.5). The PVT group showed longer cold ischemic time (CIT), hospital stay, and intensive care unit stay and significantly shorter 1-year survival rate (63.3%) compared to the non-PVT group (86.7%) (P = 0.003). Those with PVT grades I, II, and III had 1-year survival rates of 72.5%, 50%, and 40%, respectively.
Preoperative PVT reduces the 1-year survival after transplantation, with patients with higher PVT grades exhibiting lower 1-year survival. LDLT for PVT still remains challenging and requires further studies.
门静脉血栓形成（PVT）不再是活体肝移植（LDLT）的绝对禁忌证。本研究旨在评估 LDLT 的短期结果，并比较术前存在和不存在 PVT 的患者的 1 年生存率。
本研究为前瞻性和回顾性队列研究，纳入 2008 年至 2020 年在 Ain Shams 器官移植中心（ASCOT）接受 LDLT 的 60 例 PVT 患者和 60 例无 PVT 患者。比较两组患者的术前数据、手术细节、术后并发症和 1 年生存率。
大多数 PVT 患者为 Child C 级（65%），且模型终末期肝病评分（16.23±4.03）高于非 PVT 组（13.9±4.5）。PVT 组冷缺血时间（CIT）、住院时间和重症监护病房停留时间较长，1 年生存率（63.3%）明显低于非 PVT 组（86.7%）（P=0.003）。PVT 分级为 I、II 和 III 的患者 1 年生存率分别为 72.5%、50%和 40%。
术前 PVT 降低移植后 1 年生存率，PVT 分级较高的患者 1 年生存率较低。PVT 的 LDLT 仍然具有挑战性，需要进一步研究。
