Trasplante hepático en pacientes con trombosis de la vena porta

Liver transplantation in patients with portal vein thrombosis Portalveinthrombosis�(PVT)�isaseriouscomplicationofend-stageliverdisease,�representingacha- llengeforthelivertransplantation�(LT)�team.�TheaimofthisstudywastoanalyzetheresultsofLTinpatients� withPVT.�Methods: AlladultpatientswhounderwentaLTfromacadavericdonorbetweenMarch�1994�and� March�2010�wereincluded.�PVTwascategorizedusingtheclassificationofYerdelandMcMaster.�Results: A totalof�109�LTwereperformedin�105�patients.�PVTwasfoundin�13�cases�(12.4%).�In�6�ofthem�(46.2%),� thrombosiswasfoundpreoperativelybytransplantroutineworkup.�Pre-transplantsystemicanticoagulation� wasindicatedin�3�cases.�Atthetimeofsurgery,�only�10�patientshadpersistentPVT.�GradeI,�II,�IIIandIV� PVTwasfoundon�2,�3,�4�and�1�patientrespectively.�Inthe�3�casestreatedwithsystemicanticoagulationpreo- peratively,�gradeI�(1�case)�andgradeII�(2�cases)�nothrombuswasevidentintraoperatively.�Endovenectomy� wasperformedin�7�cases;�simplethrombectomyinoneandamesentericveingraftwasrequiredin�2�cases.� Nothrombusrecurrencewasdetectedonpostoperativefollow-up.�In-hospitalmortalityoccurredin�2�cases� withPTVgradeIIIandIVduetomedicalcomplications.�One-yearpatientandgraftsurvivalwas�69%�vs� 79%�inpatientswithoutPVT�(p�=�0,476).�Conclusion:�LivertransplantinpatientswithPVTthrombosiswas� notassociatedwithasignificantincreasedriskofmortality.�Systemicanticoagulationseemstobewarranted� whilewaitingforlivertransplantation.