Obesity is an independent risk factor for pre-transplant portal vein thrombosis in liver recipients

Abstract

Background: Portal vein thrombosis is a frequent complication in end-stage cirrhosis with a considerable peri-operative risk for liver transplant candidates. We aimed to characterize the pre-transplant portal vein thrombosis in a cohort of liver transplant recipients, and to identify independent risk factors for this complication.

Methods: 380 consecutive primary orthotopic liver transplants were performed in the Digestive Surgery Department of "12 de Octubre" Hospital (Madrid, Spain), between January 2001 and December 2006. The main risk factors considered were smoking, obesity, metabolic disorders, previous immobility, surgery or trauma, nephrotic syndrome, associated tumor, inflammatory disease, neoplasm myeloprolipherative. Furthermore we have reported genetic thrombophilia results for 271 recipients.

Results: Sixty-two (16.3%) patients developed pre-transplant portal vein thrombosis and its presence had no impact in the overall survival of liver recipients. Obesity was the only independent risk factor for pre-transplant portal vein thrombosis.

Conclusion: We recommend close control of cardiovascular factors in patients with liver cirrhosis in order to avoid associated thrombosis.

Figure 1

Recipient Overall Survival. Kaplan-Meier analyses of OS with respect to the presence of pre-transplant PVT. There was no association of pre-transplant PVT with recipient OS (P = 0.989). OS was not different between liver recipients with pre-transplant PVT (n = 59 evaluated cases; 79.18%) and without pre-transplant PVT (n = 317; 79.66%). 4 cases were not evaluated for OS. Cumul Survival (Cumulative Survival); pre-transplant PVT (pre-transplant portal vein thrombosis).