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ORIGINAL ARTICLE
Year : 2018  |  Volume : 37  |  Issue : 2  |  Page : 191-195

Portal vein thrombosis with cirrhosis: is it an indication for early liver transplantation?


1 Department of General Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
2 Department of Tropical Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Correspondence Address:
Hany Said
Department of General Surgery, Faculty of Medicine, Ain Shams University, Abassia, Cairo, 12555
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ejs.ejs_145_17

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Introduction Portal vein thrombosis (PVT) is an independent risk factor for perioperative mortality and graft loss but not long-term outcomes in patients with cirrhosis after LT. The aim of this study was to assess the effect of timing of Living Donor Liver Transplantation (LDLT) on early results in patients with cirrhosis with PVT and decompensated liver (early vs. late). This was a retrospective study. Patients and methods This study included 24 patients with cirrhosis with PVT who underwent LDLT between January 2015 and June 2017 in Ain Shams University Hospitals. Fifteen patients were Child C and Model for End stage Liver Disease (MELD) more than 15 (group A) at time of transplantation and nine patients were transplanted early (Child B and MELD <15) owing to other indications, for example, Hepato Celluluar Carcinoma (HCC) (group B). Comparisons were done between both groups regarding operative data and perioperative mortality. Results Both groups were comparable in age, sex, etiology of liver disease, and presence of HCC. Operation in group B was easier than in group A, with statistically significant difference regarding operative time (7.4±1.2 vs. 10±2.1 h, P=0.002), need for blood transfusion (55.6 vs. 100%, P=0.005), and amount of blood transfusion [2 U (0–6) vs. 3 U (1–10) (P=0.048)]. Blood loss was only significantly lower in group B at 1900 ml (700–2600) versus 3000 (1000–6000) in group A (P=0.073). No statistically significant differences in ICU stay (P=0.570), hospital stay (P=0.432), and perioperative mortality (22.2 vs. 26.7%) were observed in group B and group A (P=0.562). Conclusion LDLT in patients with cirrhosis with PVT is technically more feasible when done early (Child B and MELD <15), but this is not associated with better outcome. PVT in patients with cirrhosis is not an indication for early transplantation.


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