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Thrombosis Confined to the Portal Vein Is Not a Contraindication for Living Donor Liver Transplantation

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Abstract

Background

There is a lack of agreement regarding preexisting portal vein thrombosis (PVT) in patients undergoing living donor liver transplantation (LDLT). We report the results of a single-center study to determine the impact of PVT on outcomes of adult LDLT recipients.

Methods

Of 133 cases of adult LDLT performed between January 2000 and December 2004, a thrombectomy was performed on 22 patients (16.5%) with PVT during the transplant procedure. One hundred eleven patients without PVT (group 1) were compared with those with a thrombosis confined to the portal vein (group 2; n = 15) and patients with the thrombosis beyond the portal vein (group 3; n = 7).

Results

The sensitivities of Doppler ultrasound and CT in detecting PVT were 50 and 63.6%. A prior history of variceal bleeding (OR = 10.6, p = 0.002) and surgical shunt surgery (OR = 28.1, p = 0.044) were found to be an independent risk factors for PVT. The rate of postoperative PVT was significantly higher in patients with PVT than in those without (18.2 vs. 2.7%; p = 0.014). In particular, the rethrombosis rate in group 3 was 28.6%. The actuarial 3-year patient survival rate in PVT patients (73.6%) was similar to that of the non-PVT patients (85.3%; p = 0.351). However, the actuarial 3-year patient survival rate in group 3 was 38.1%, which was significantly lower than that in groups 1 and 2 (p = 0.006).

Conclusion

A thrombosis confined to the portal vein per se should not be considered a contraindication for LDLT.

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Authors and Affiliations

  1. Department of Surgery, Seoul National University College of Medicine, Seoul National University Hospital, 28 Yongon-dong, Chongno-gu, Seoul, 110-744, Korea

    Jai Young Cho, Kyung-Suk Suh, Woo Young Shin, Hae Won Lee, Nam-Joon Yi & Kuhn Uk Lee

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  1. Jai Young Cho
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  2. Kyung-Suk Suh
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Correspondence to Kyung-Suk Suh.

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Cho, J.Y., Suh, KS., Shin, W.Y. et al. Thrombosis Confined to the Portal Vein Is Not a Contraindication for Living Donor Liver Transplantation. World J Surg 32, 1731–1737 (2008). https://doi.org/10.1007/s00268-008-9651-4

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