Clinical Research On Portal Vein Thrombosis In Liver Transplantation

Objective:To analyze risk factors of portal vein thrombosis before liver transplantation,the PVT influence on liver transplantation procedure and outcomes post liver transplantation.Background:Portal vein thrombosis has been defined as the formation of thrombus within Portal vein,including tributary of portal vein(Splenic vein and Superior mesenteric vein).Portal vein thrombosis has been considered as a contraindication for a long time.With the rapid progress of surgical technique,portal vein thrombosis has not been considered as a contraindication and most publications reported portal vein thrombosis did not influence the prognosis.However,some papers reported portal vein thrombosis might decrease short-term survival and increase difficulty during operation.So it is quite important to study portal vein thrombosis in liver transplantation.Method:We Retrospect non-tumor liver transplantation patients in the first hospital affiliated to Zhejiang University between 2015.1.1 to 2018.9.3.Through pre-operation imaging test and operation record to select 44 cases with portal vein.According to the age,sex and etiology,using the PSM approach to select 44 cases without portal vein in the same period.Compare the general history,coagulation function before liver transplantation to identify possible risk factors for formation of portal vein thrombus.Collecting operation records,post-transplantation complications and short-,long-term survival to study the influence on operation and survival.Results:Compared to non-PVT group,splenectomy history,varices of esophageal gastric vein,ligation of esophageal gastric vein and hemorrhage of digestive tract has been found clear distinguish pre-transplantation(P<0.05).In the area of liver transplantation procedure,PVT group owns longer operation time,309.5 minutes(269?388),P=0.039 and more consumption of RBC transfusion,7U(4.81?10),P=0.017.In the post-transplantation complications,PVT group might face more frequent re-thrombosis incidence(P=0.00).Survival between the two groups does not been found difference,the cumulative survival in PVT group was 77.06%,in non-PVT group was 62.61%.Conclusion:Existence of portal vein thrombosis does not influence the long and short-term survival.But it might increase the usage of RBC transfusion and prolong operation time.It also increase the rates of portal vein re-thrombosis.Possible risk factors include splenectomy history,varices of esophageal gastric vein,ligation of esophageal gastric vein and hemorrhage of digestive tract.