Journal ArticleDOI
Pre-existent portal vein thrombosis in liver transplantation: influence of pre-operative disease severity.
Axel Doenecke,Tung-Yu Tsui,Carl Zuelke,Marcus N. Scherer,Andreas A. Schnitzbauer,HJ Schlitt,Aiman Obed +6 more
TLDR
Doenecke A, Tsui T‐Y, Zuelke C, Scherer MN, Schnitzbauer AA, Schlitt H‐J, Obed A. Pre‐existent portal vein thrombosis in liver transplantation: influence of pre‐operative disease severity.Abstract:
Doenecke A, Tsui T-Y, Zuelke C, Scherer MN, Schnitzbauer AA, Schlitt H-J, Obed A. Pre-existent portal vein thrombosis in liver transplantation: influence of pre-operative disease severity. Clin Transplant 2010: 24: 48–55. © 2009 John Wiley & Sons A/S.
Abstract: Background: Portal vein thrombosis (PVT) is a surgical challenge in liver transplantation (LTx). In contrast to LTx in decompensated liver disease, which are associated with a higher morbidity and mortality, PVT influence on outcome is still under debate. To evaluate this influence at different stages of liver decompensation, we compared the outcome of patients suffering from PVT to patients with patent portal vein within different score ranges.
Methods: We included 193 LTx (24 with PVT) in our study, transplanted between 2004 and 2007 at our institution. Patients were divided into four Model of End-Stage Liver Disease (MELD) score groups, and outcome was compared between PVT- and non-PVT patients.
Results: In non-decompensated liver disease (MELD 15 (decompensated liver disease) leads to an equal or even better survival in PVT-patients compared with patients without PVT (one-yr survival 91% vs.75%), with an only slightly increased morbidity.
Conclusion: Outcome in patients with PVT seems to be dependent on pre-operative disease severity. In contrast to compensated liver disease, no influence of PVT on outcome could be found in decompensated liver disease, and should therefore not be considered as a contraindication in LTx.read more
Citations
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Journal ArticleDOI
Hypercoagulability in cirrhosis: causes and consequences†
Armando Tripodi,Quentin M. Anstee,Kirstine Kobberøe Søgaard,Massimo Primignani,Dominique Valla +4 more
TL;DR: The possible consequences that are discussed herein include whether cirrhosis is a condition associated with increased risk of venous thromboembolism or portal vein thrombosis; the hypercoagulability associated with Cirrhosis has any other role outside coagulation (i.e. progression of liver fibrosis); and anticoagulation should be used in cir rhosis.
Journal ArticleDOI
Systematic review: portal vein thrombosis in cirrhosis.
TL;DR: In this paper, a systematic review of nonmalignant portal vein thrombosis in cirrhosis in terms of prevalence, pathogenesis, diagnosis, clinical course and management was performed.
Journal ArticleDOI
Management of Nonneoplastic Portal Vein Thrombosis in the Setting of Liver Transplantation : A Systematic Review
Kryssia I. Rodriguez-Castro,Robert J. Porte,E. Nadal,Giacomo Germani,Giacomo Germani,Patrizia Burra,Marco Senzolo +6 more
TL;DR: Screening for this condition is essential, alongside adequate treatment strategies to attempt repermeation of the PV and prevent thrombosis extension, and it affects survival when it is complete, at least in the short term after transplant.
Journal ArticleDOI
Review article: the modern management of portal vein thrombosis.
TL;DR: Background Portal vein thrombosis is an important cause of portal hypertension and may occur as such with or without associated cirrhosis and hepatocellular carcinoma.
Journal ArticleDOI
Management of portal vein thrombosis in liver cirrhosis
TL;DR: The possibility of spontaneous resolution of partial PVT questions the necessity of anticoagulation for the treatment ofpartial PVT, and a relatively low recanalization rate of complete PVT after antICOagulation therapy suggests its limited usefulness in patients with complete PVt.
References
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Journal ArticleDOI
A model to predict survival in patients with end‐stage liver disease
Patrick S. Kamath,Russell H. Wiesner,Michael Malinchoc,Walter K. Kremers,Terry M. Therneau,Catherine L. Kosberg,Gennaro D'Amico,E. Rolland Dickson,M.B.A. W. Ray Kim M.D. +8 more
TL;DR: The MELD scale is a reliable measure of mortality risk in patients with end‐stage liver disease and suitable for use as a disease severity index to determine organ allocation priorities in patient groups with a broader range of disease severity and etiology.
Journal ArticleDOI
A model to predict survival in patients with end-stage liver disease
Patrick S. Kamath,Russell H. Wiesner,Michael Malinchoc,Walter K. Kremers,Terry M. Therneau,Gennaro D'Amico,Catherine L. Kosberg,E. R. Dickson,W. R. Kim +8 more
TL;DR: The MELD scale is a reliable measure of mortality risk in patients with end-stage liver disease and suitable for use as a disease severity index to determine organ allocation priorities in patient groups with a broader range of disease severity and etiology.
Journal ArticleDOI
Portal vein thrombosis in adults undergoing liver transplantation: risk factors, screening, management, and outcome.
M A Yerdel,Bridget Gunson,Darius F. Mirza,K. Karayalcin,Simon Olliff,John A. C. Buckels,David Mayer,P McMaster,Jacques Pirenne +8 more
TL;DR: PVT patients undergo more difficult surgery, have more postoperative complications, have higher in-hospital mortality rates, and have reduced 5-year survival rates, whereas patients with grades 2, 3, and 4 PVT had reduced survival rates.
Journal ArticleDOI
The spectrum of portal vein thrombosis in liver transplantation.
Andrei C. Stieber,Giorgio Zetti,Satoru Todo,Andreas G. Tzakis,John J. Fung,Ignazio R. Marino,A. Casavilla,Robert R. Selby,Thomas E. Starzl +8 more
TL;DR: It is concluded that a vast majority of the patients with thrombosis of the portal system can be technically transplanted and that their survival rate is comparable to that of patients with patent portal vein.
Journal ArticleDOI
MELD and prediction of post–liver transplantation survival
Shahid Habib,Brian S. Berk,Chung Chou H. Chang,Anthony J. Demetris,Paulo Fontes,Igor Dvorchik,Bijan Eghtesad,Amadeo Marcos,A. Obaid Shakil +8 more
TL;DR: Older patient and donor age, male sex of recipient, retransplantation, and high pretransplant MELD score are associated with poor posttransplant outcome, and better prognostic models are needed to provide an overall assessment of transplant benefit relative to the severity of hepatic dysfunction.
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