Abstracts of the 2023 Annual Meeting of the ALEH
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Introduction and ObjectivesThrombosis of the portal venous (PVT) system is a frequent and potentially life-threatening condition in patients with liver disease. Percutaneous interventional procedures have gained worldwide acceptance for alleviating the symptoms of portal hypertension.
The objective of this study is to evaluate the impact of portal plasty on patients with decompensated cirrhosis and to analyze the correlations between different prognostic scales, laboratory and imaging results to determine the postoperative prognosis in these patients.
Patients / Materials and MethodsWe included 13 patients with liver cirrhosis and chronic portal thrombosis with portal plasty ± TIPS. Data collection tools involved reviewing the clinical histories of the patients to obtain necessary data such as platelets, sodium, liver function tests, and findings via tomography to evaluate ascites and splenomegaly. Calculation tools from Stanford University were used to determine MELD, MELD Na, and MELD 3.0 scores. Finally, a descriptive analysis was performed for all collected variables. Descriptive statistics were analyzed using means for continuous variables.
Results and DiscussionPatients with portal plasty had the following outcomes at 3 months: delta MELD-Sodium -1.2 points, which paralleled an improvement in sodium levels with a delta +2.4 meq/L. This could be due to the improvement of the hypervolemic state, 100% of the patients presented some degree of improvement in ascites as assessed by abdominal tomography.
The platelet count presented a delta of +16,000 platelets, reflecting an improvement of portal hypertension and splenomegaly.
The small decrease in MELD 3.0 can be explained by the improvement in serum albumin levels by 0.8 g/dL, which could reflect less inflammation in patients with chronic thrombosis. There was no significant difference in Child Pugh, hemoglobin, creatinine, bilirubin and coagulation tests.
Two patients were included in the transplant list and were transplanted successfully.
ConclusionsPortal plasty ± TIPS in patients with cirrhosis and chronic thrombosis is a viable treatment with clinical and biochemical benefits, with minimal adverse effects, which can be used as a bridging therapy for liver transplantation.
