Portal vein thrombosis and renal dysfunction: a national comparative study of liver transplant recipients for NAFLD versus alcoholic cirrhosis.


Journal

Transplant international : official journal of the European Society for Organ Transplantation
ISSN: 1432-2277
Titre abrégé: Transpl Int
Pays: Switzerland
ID NLM: 8908516

Informations de publication

Date de publication:
06 2021
Historique:
revised: 08 03 2021
received: 22 01 2021
accepted: 19 03 2021
pubmed: 30 3 2021
medline: 3 7 2021
entrez: 29 3 2021
Statut: ppublish

Résumé

The prevalence of portal vein thrombosis (PVT), renal dysfunction (RD), and simultaneous PVT/RD in liver transplantation (LT) is poorly understood. We analyzed the prevalence of PVT, RD, simultaneous PVT/RD, and the outcomes of adult recipients of LT for nonalcoholic fatty liver disease (NAFLD) and alcoholic liver disease (ALD) between 2006 and 2016 in the United States. We found that the prevalence of PVT (7.2% → 11.3%), RD (33.8% → 39.2%), and simultaneous PVT/RD (2.4% → 4.5%) has increased significantly over the study period (all P-values <0.05). NAFLD patients had a higher proportion of PVT (14.8% vs. 9.2%), RD (45.0% vs. 42.1%), and simultaneous PVT/RD (6.5% vs. 3.9%; all P-values <0.05). 90-day mortality was 3.8%, 6.3%, 6.8%, and 9.8% for PVT(-)/RD(-), PVT(-)/RD(+), PVT(+)/RD(-), and PVT(+)/RD(+) recipients, respectively (P < 0.01). 5-year survival was 82.1%, 75.5%, 74.8%, and 71.1% for PVT(-)/RD(-), PVT(-)/RD(+), PVT(+)/RD(-), and PVT(+)/RD(+) recipients, respectively (P < 0.05). In conclusion, the prevalence of PVT, RD, and simultaneous PVT/RD has increased among LT recipients, especially for those with NAFLD. The short- and long-term outcomes of recipients with PVT, RD, and simultaneous PVT/RD were inferior to patients without those risk factors irrespective of their indication for LT. No differences in patient outcomes were found between ALD and NAFLD recipients after stratification by risk factors.

Identifiants

pubmed: 33780554
doi: 10.1111/tri.13873
pmc: PMC8360094
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1105-1122

Subventions

Organisme : none
ID : na

Commentaires et corrections

Type : CommentIn

Informations de copyright

© 2021 The Authors. Transplant International published by John Wiley & Sons Ltd on behalf of Steunstichting ESOT.

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Auteurs

Michele Molinari (M)

Department of Surgery, UPMC Montefiore Hospital, Pittsburgh, PA, USA.

Carlos Fernandez-Carrillo (C)

Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Department of Surgery, University of Leeds, Leeds, UK.

Dongling Dai (D)

Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

Jorgensen Dana (J)

Department of Surgery, UPMC Montefiore Hospital, Pittsburgh, PA, USA.

Ana Clemente-Sanchez (A)

Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

Stalin Dharmayan (S)

Department of Surgery, UPMC Montefiore Hospital, Pittsburgh, PA, USA.

Christof Kaltenmeier (C)

Department of Surgery, UPMC Montefiore Hospital, Pittsburgh, PA, USA.

Hao Liu (H)

Department of Surgery, UPMC Montefiore Hospital, Pittsburgh, PA, USA.

Jaideep Behari (J)

Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

Vikrant Rachakonda (V)

Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

Swaytha Ganesh (S)

Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

Christopher Hughes (C)

Department of Surgery, UPMC Montefiore Hospital, Pittsburgh, PA, USA.

Amit Tevar (A)

Department of Surgery, UPMC Montefiore Hospital, Pittsburgh, PA, USA.

Hasan Al Harakeh (H)

Department of Surgery, UPMC Montefiore Hospital, Pittsburgh, PA, USA.

Bishoy Emmanuel (B)

Department of Surgery, UPMC Montefiore Hospital, Pittsburgh, PA, USA.

Abhinav Humar (A)

Department of Surgery, UPMC Montefiore Hospital, Pittsburgh, PA, USA.

Ramon Bataller (R)

Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

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