Association between Portal Vein Thrombosis and Survival of Liver Transplant Recipients: a Systematic Review and Meta-analysis of Observational Studies

Qi, Xingshun; Dai, Junna; Jia, Jia; Ren, Weirong; Yang, Man; Li, Hongyu; Fan, Daiming; Guo, Xiaozhong

doi:10.15403/jgld.2014.1121.qix

Cited by 55 publications

(52 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the study by Pécora et al, the patients with PVT grade I presented a 5 y survival rate identical to controls (86%); but patients with degrees II, III and IV had lower survivals [1] as shown in our series. Qi et al, showed that the recipients with preoperative PVT, especially with complete thrombosis, had no statistically significant difference in perioperative or five year survival rate than patients without PVT [30].…”

Section: Discussionmentioning

confidence: 99%

Living Donor Liver Transplantation for Patients with Pre-existent Portal Vein Thrombosis

Zakaria¹,

Taha²,

Gad³

et al. 2017

J Liver

View full text Add to dashboard Cite

Background: Portal vein thrombosis (PVT) in living donor liver transplantation (LDLT) is a surgical challenge with technical difficulty. The aim of this study was to analyze the operative planning for management of PVT in LDLT and the impact of PVT on the outcome in comparison to patients without PVT. Methods: Between July 2003 to August 2016, 213 patients underwent LDLT. The patients were divided into two groups with and without PVT. The preoperative, operative, and postoperative data were analysed. Results: Thirty six patients (16.9%) had different grades of PVT at time of liver transplantation (LT); grades I, II, III and IV were 18 (50%), 14 (38.9%), 3 (8.3%) and 1 patient (2.8%) respectively. The management of PVT was by; thrombectomy in 31 patients (86%), bypass graft in 2 patients (5.6%), portal replacement graft in 1 patient (2.8%), anastomosis with the left renal vein in 1 patient (2.8%) and with large collateral vein in 1 patient (2.8%). Overall postoperative PVT occurred in 10 patients (4.7%), 4 patients of them had preoperative PVT. The perioperative mortality in patients with PVT, and patients without PVT was 33.3%, and 20.3%, respectively (P=0.17). The 1-, 3-, 5-, and 7y survival in patients with PVT was 49.7%, 46.2%, 46.2%, 46.2% respectively and in patients without PVT it was 65%, 53.7%, 50.8%, 49% respectively (P=0.29). Conclusions: Preoperative PVT may not keep a patient from undergoing successful LT with comparable outcome to patients without PVT specially with partial PVT.

show abstract

Section: Discussionmentioning

confidence: 99%

Living Donor Liver Transplantation for Patients with Pre-existent Portal Vein Thrombosis

Zakaria¹,

Taha²,

Gad³

et al. 2017

J Liver

View full text Add to dashboard Cite

show abstract

“…Generally, overall morbidity and mortality in LT recipients of are not influenced by the presence of PVT [ 83 ]. However, in a recent meta-analysis [ 84 ], it was demonstrated that LT recipients with pre-LT PVT had a significantly lower 1-year survival rate compared to those without (odds ratio [OR] 0.733, 95% confidence interval [CI] 0.621-0.865). In the subgroup with complete PVT, the prognostic value was more pronounced (OR 0.503, 95%CI 0.295-0.858), but the impact of PVT on the 5-year survival was not significant.…”

Section: Pvt and Ltmentioning

confidence: 99%

Portal vein thrombosis in cirrhosis: diagnosis, natural history, and therapeutic challenges

Mantaka

Augoustaki

Kouroumalis

et al. 2018

aog

View full text Add to dashboard Cite

Portal vein thrombosis (PVT) is a frequent complication in cirrhosis and its prevalence increases with disease severity. Several factors are involved in the development and progression of PVT. The challenge for the management of PVT is the precise evaluation of the bleeding risk as opposed to life-threatening extension of thrombosis. Nevertheless, the impact on the progression and outcome of liver disease is unclear. A critical evaluation of the available data discloses that treating PVT in cirrhotics is safe and effective. However, there are open issues, such as which anticoagulant could represent a safer therapeutic option, and when and for how long this treatment should be administered to cirrhotic patients with PVT.

show abstract

“…Portal venous system thrombosis (PVST) refers to the formation of a thrombus within the intrahepatic portal vein branches, main portal vein (MPV), splenic vein (SV), and superior mesenteric vein (SMV) [ 1 , 2 ]. Given the relatively high prevalence and negative prognostic impact of PVST in liver cirrhosis [ 3 – 6 ], understanding the risk factors of PVST is important to optimize the prevention strategy in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Splenectomy Causes 10-Fold Increased Risk of Portal Venous System Thrombosis in Liver Cirrhosis Patients

Han

Yuan

et al. 2016

Med Sci Monit

Self Cite

View full text Add to dashboard Cite

BackgroundPortal venous system thrombosis (PVST) is a life-threatening complication of liver cirrhosis. We conducted a retrospective study to comprehensively analyze the prevalence and risk factors of PVST in liver cirrhosis.Material/MethodsAll cirrhotic patients without malignancy admitted between June 2012 and December 2013 were eligible if they underwent contrast-enhanced CT or MRI scans. Independent predictors of PVST in liver cirrhosis were calculated in multivariate analyses. Subgroup analyses were performed according to the severity of PVST (any PVST, main portal vein [MPV] thrombosis >50%, and clinically significant PVST) and splenectomy. Odds ratios (ORs) and 95% confidence intervals (CIs) were reported.ResultsOverall, 113 cirrhotic patients were enrolled. The prevalence of PVST was 16.8% (19/113). Splenectomy (any PVST: OR=11.494, 95%CI=2.152–61.395; MPV thrombosis >50%: OR=29.987, 95%CI=3.247–276.949; clinically significant PVST: OR=40.415, 95%CI=3.895–419.295) and higher hemoglobin (any PVST: OR=0.974, 95%CI=0.953–0.996; MPV thrombosis >50%: OR=0.936, 95%CI=0.895–0.980; clinically significant PVST: OR=0.935, 95%CI=0.891–0.982) were the independent predictors of PVST. The prevalence of PVST was 13.3% (14/105) after excluding splenectomy. Higher hemoglobin was the only independent predictor of MPV thrombosis >50% (OR=0.952, 95%CI=0.909–0.997). No independent predictors of any PVST or clinically significant PVST were identified in multivariate analyses. Additionally, PVST patients who underwent splenectomy had a significantly higher proportion of clinically significant PVST but lower MELD score than those who did not undergo splenectomy. In all analyses, the in-hospital mortality was not significantly different between cirrhotic patient with and without PVST.ConclusionsSplenectomy may increase by at least 10-fold the risk of PVST in liver cirrhosis independent of severity of liver dysfunction.

show abstract

Association between Portal Vein Thrombosis and Survival of Liver Transplant Recipients: a Systematic Review and Meta-analysis of Observational Studies

Cited by 55 publications

References 42 publications

Living Donor Liver Transplantation for Patients with Pre-existent Portal Vein Thrombosis

Living Donor Liver Transplantation for Patients with Pre-existent Portal Vein Thrombosis

Portal vein thrombosis in cirrhosis: diagnosis, natural history, and therapeutic challenges

Splenectomy Causes 10-Fold Increased Risk of Portal Venous System Thrombosis in Liver Cirrhosis Patients

Contact Info

Product

Resources

About