Living donor liver transplantation for patients with portal vein thrombosis: high-volume single center experience

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dc.authorscopusid57196057777
dc.authorscopusid25959851900
dc.authorscopusid57210692428
dc.authorscopusid6505800247
dc.authorscopusid57218480099
dc.authorscopusid6602271303
dc.contributor.authorElsarawy A.
dc.contributor.authorAkbulut S.
dc.contributor.authorAktas S.
dc.contributor.authorKilercik H.
dc.contributor.authorAlkara U.
dc.contributor.authorSevmis S.
dc.date.accessioned2024-08-04T20:00:48Z
dc.date.available2024-08-04T20:00:48Z
dc.date.issued2024
dc.departmentİnönü Üniversitesien_US
dc.description.abstractOBJECTIVE: End-stage liver disease is commonly associated with portal vein thrombosis (PVT). Lastly, PVT is no longer an absolute contraindication for liver transplantation, and many centers adopt portal vein thrombectomy. PVT imposes special technical difficulties during living donor liver transplantation (LDLT). In this research, the experience with PVT cases during LDLT in a high-volume center is introduced. PATIENTS AND METHODS: Between January 2018 and July 2023, 312 patients underwent LDLT. After 88 cases were excluded, 224 cases were included, and their incidence of pre-transplant PVT was 16.5% (37/224). Demographic and clinical features, perioperative variables, and post-transplant outcomes of patients with PVT (PVT group, n=37) were compared to patients who had no PVT (non-PVT group, n=187). RESULTS: According to Yerdel classification, 16, 16, 2, and 3 patients had PVT grade I, II, III, and IV, respectively. Complete venous thrombectomy was accomplished in 34 patients, while for three patients, thrombectomy was not feasible, and graft inflow was established by interposition vascular graft. For portal flow modulation, splenectomy and splenic artery ligation were performed in 7 and 4 patients, respectively, while two patients underwent post-transplant splenic artery embolization. The PVT group had longer operation time (p<0.001), longer warm ischemia time (p=0.031), longer anhepatic phase (p<0.001), and intraoperatively required more than 3 packed RBCs units (p=0.029) and ?1 platelet unit transfusion (p=0.021) than the non- PVT group. No statistically significant difference was found between groups in terms of re-exploration (p=0.954), post-transplant PVT (p=0.375), biliary (p=0.253) and arterial complications (p=0.593), ICU stay (p=0.633), hospital stay (p=896), and 30-day mortality (p=1.000). Survival analysis showed no statistically significant difference regarding 1-year survival (p=0.176) between both groups. CONCLUSIONS: This study showed that patients with different stages of PVT can successfully undergo LDLT in experienced centers and that they do not differ from patients without PVT in terms of post-transplant complications. © 2024 Verduci Editore s.r.l. All rights reserved.en_US
dc.identifier.doi10.26355/eurrev_202406_36380
dc.identifier.endpage3760en_US
dc.identifier.issn1128-3602
dc.identifier.issue11en_US
dc.identifier.pmid38884510en_US
dc.identifier.scopus2-s2.0-85196123374en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpage3752en_US
dc.identifier.urihttps://doi.org/10.26355/eurrev_202406_36380
dc.identifier.urihttps://hdl.handle.net/11616/91024
dc.identifier.volume28en_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherVerduci Editore s.r.len_US
dc.relation.ispartofEuropean Review for Medical and Pharmacological Sciencesen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectLiving donor liver transplantationen_US
dc.subjectPortal vein thrombosisen_US
dc.subjectPostoperative complicationsen_US
dc.subjectSurvivalen_US
dc.subjectThrombectomyen_US
dc.titleLiving donor liver transplantation for patients with portal vein thrombosis: high-volume single center experienceen_US
dc.typeArticleen_US

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