P-26 PORTAL VENOUS THROMBOSIS IN TRANSPLANTED CIRRHOTIC PATIENTS AT THE “HOSPITAL CLÍNICO UNIVERSIDAD DE CHILE”

Background

Portal vein thrombosis (PVT) is a frequent complication in cirrhotic patients on the waiting list for liver transplantation (LT); this is associated with increased post-LT mortality.

Objective

Characterize the presence of PVT in patients with LT.

Methods

Retrospective observational study between January 1, 2014 and February 28, 2018. Clinical records, laboratory and images were reviewed.

Results

82 patients were included; Age 58 (21-71) years; Etiology: non-alcoholic fatty liver 40.2%, alcoholic liver disease 20.7%, autoimmunity 13.4%, and hepatitis C 8.5%; Child-Pugh: 7.3% A, 30.4% B and 62.2% C; MELD-Na 22 (8-40). PVT was diagnosed before or during LT in 26.8%: Child A 16.6%, B 16.0%, and C 33.3%; MELD-Na 25 (12-40) in those with PVT vs 21 (8-40) in those without PVT (non significant, NS); 34% had hepatocarcinoma (32.1% with PVT vs. 24.4% without PVT; NS). Diagnosis of PVT was 77.2% pre LT and almost 1/4 during transplant surgery. The extension of the PVT was complete occlusion in 11.7%, partial in 70.5%; 11.7% had only intrahepatic branches compromised (1 case with incomplete data). In 76% of the patients anticoagulation (AC) was started during waiting list; none had complications associated to AC. Complete re-canalization was achieved in 53.8%. The 5-year survival was 70%; 71.7% in those without PVT and 63.6% in those with PVT (NS).

Conclusion

PVT is a frequent complication in cirrhotic patients in the waiting list who received LT. Most receive AC without complications. The 5-year survival in this series was similar despite the presence of PVT.

Selected subject area: Liver Transplantation.