Outcome of living donor liver transplantation in patients with preoperative portal vein thrombosis.


Journal

Arab journal of gastroenterology : the official publication of the Pan-Arab Association of Gastroenterology
ISSN: 2090-2387
Titre abrégé: Arab J Gastroenterol
Pays: Egypt
ID NLM: 101298363

Informations de publication

Date de publication:
Aug 2022
Historique:
received: 28 12 2021
revised: 14 02 2022
accepted: 21 03 2022
pubmed: 11 6 2022
medline: 24 9 2022
entrez: 10 6 2022
Statut: ppublish

Résumé

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.

Sections du résumé

BACKGROUND AND STUDY AIMS OBJECTIVE
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.
PATIENTS AND METHODS METHODS
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.
RESULTS RESULTS
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.
CONCLUSION CONCLUSIONS
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.

Identifiants

pubmed: 35688682
pii: S1687-1979(22)00025-9
doi: 10.1016/j.ajg.2022.03.002
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

159-164

Informations de copyright

Copyright © 2022 Pan-Arab Association of Gastroenterology. Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Hazem Kamal (H)

Department of Tropical Medicine, Ain Shams Center for Organ Transplantation (ASCOT), Ain Shams University, Cairo, Egypt. Electronic address: hazem_kamal@med.asu.edu.eg.

Eman El Gendy (E)

Department of Tropical Medicine, Ain Shams Center for Organ Transplantation (ASCOT), Ain Shams University, Cairo, Egypt.

Nadia Abdelaaty Abdelkader (NA)

Department of Tropical Medicine, Ain Shams Center for Organ Transplantation (ASCOT), Ain Shams University, Cairo, Egypt.

Mohamed Bahaa (M)

Department of General Surgery, Ain Shams Center for Organ Transplantation (ASCOT), Ain Shams University, Cairo, Egypt.

Iman Fawzy Montasser (IF)

Department of Tropical Medicine, Ain Shams Center for Organ Transplantation (ASCOT), Ain Shams University, Cairo, Egypt.

Ethar M Badran (EM)

Department of Tropical Medicine, Ain Shams Center for Organ Transplantation (ASCOT), Ain Shams University, Cairo, Egypt.

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Classifications MeSH