Barrera-Lozano Luis Manuel, Ramírez-Arbeláez Jaime Alberto, Muñoz Cristian Leonardo, Becerra Jorge Andrés, Toro Luis Guillermo, Ardila Carlos M
Transplant Department, Hospital San Vicente Fundación, Rionegro 054047, Colombia.
Vascular Medicine Department, Faculty of Medicine, Universidad de Antioquia UdeA, Medellín 050010, Colombia.
J Clin Med. 2023 Jun 9;12(12):3951. doi: 10.3390/jcm12123951.
Portal vein thrombosis was considered a contraindication for liver transplantation. This study analyzes the perioperative complications and survival of liver transplant patients with portal vein thrombosis (PVT). A retrospective observational cohort study of liver transplant patients was conducted. The outcomes were early mortality (30 days) and patient survival. A total of 201 liver transplant patients were identified and 34 (17%) patients with PVT were found. The most frequent extension of thrombosis was Yerdel 1 (58.8%), and a portosystemic shunt was identified in 23 (68%) patients. Eleven patients (33%) presented any early vascular complication, PVT being the most frequent (12%). The multivariate regression analysis showed a statistically significant association between PVT and early complications (OR = 3.3, 95% confidence interval 1.4-7.7; = 0.006). Moreover, early mortality was observed in eight patients (24%), of which two (5.9%) presented Yerdel 2. For Yerdel 1, patient survival according to the extent of thrombosis was 75% at 1 year and 3 years, while for Yerdel 2, it was 65% at 1 year, and 50% at 3 years ( = 0.04). Portal vein thrombosis significantly influenced early vascular complications. Furthermore, portal vein thrombosis Yerdel 2 or higher impacts the survival of liver grafts in the short and long term.
门静脉血栓形成曾被视为肝移植的禁忌证。本研究分析了门静脉血栓形成（PVT）的肝移植患者的围手术期并发症及生存率。对肝移植患者进行了一项回顾性观察队列研究。观察指标为早期死亡率（30天）和患者生存率。共确定了201例肝移植患者，其中发现34例（17%）患有PVT。血栓最常见的扩展类型为Yerdel 1型（58.8%），23例（68%）患者存在门体分流。11例患者（33%）出现任何早期血管并发症，PVT最为常见（12%）。多因素回归分析显示PVT与早期并发症之间存在统计学显著关联（比值比=3.3，95%置信区间1.4 - 7.7；P = 0.006）。此外，8例患者（24%）观察到早期死亡，其中2例（5.9%）为Yerdel 2型。对于Yerdel 1型，根据血栓程度的患者1年和3年生存率分别为75%，而对于Yerdel 2型，1年生存率为65%，3年生存率为50%（P = 0.04）。门静脉血栓形成显著影响早期血管并发症。此外，Yerdel 2型或更高类型的门静脉血栓形成在短期和长期均影响肝移植的存活。
