Meta-analysis and systematic review: Prevalence, graft failure, mortality, and post-operative thrombosis in liver transplant recipients with pre-operative portal vein thrombosis.

Autor: Yeo JW; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Law MSN; Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore, Singapore., Lim JCL; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Ng CH; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Tan DJH; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Tay PWL; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Syn N; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.; Biostatistics & Modelling Domain, Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore., Tham HY; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Huang DQ; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.; Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, Singapore., Siddiqui MS; Division of Gastroenterology and Hepatology, Virginia Commonwealth University, Richmond, Virginia, USA., Iyer S; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.; Division of Hepatobiliary & Pancreatic Surgery, Department of Surgery, National University Hospital, National University Health System, Singapore, Singapore., Muthiah M; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.; Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, Singapore.
Jazyk: angličtina
Zdroj: Clinical transplantation [Clin Transplant] 2022 Feb; Vol. 36 (2), pp. e14520. Date of Electronic Publication: 2021 Nov 07.
DOI: 10.1111/ctr.14520
Abstrakt: Aims: This study seeks to evaluate the association between pre-transplant portal vein thrombosis (PVT) and overall survival, graft failure, waitlist mortality, and post-operative PVT after liver transplantation.
Methods: A conventional pairwise meta-analysis between patients with and without pre-transplant PVT was conducted using hazard ratios or odds ratios where appropriate.
Results: Prevalence of preoperative PVT was 11.6% (CI 9.70-13.7%). Pre-operative PVT was associated with increased overall mortality (HR 1.45, 95% CI 1.27-1.65) and graft loss (HR 1.58, 95% CI 1.34-1.85). In particular, grade 3 (HR 1.59, 95% CI 1.00-2.51) and 4 (HR 2.24, 95% CI 1.45-3.45) PVT significantly increased mortality, but not grade 1 or 2 PVT. Patients with PVT receiving living donor (HR 1.54, 95% CI 1.24-1.91) and deceased donor (HR 1.52, 95% CI 1.21-1.92) liver transplantation had increased mortality, with no significant difference between transplant types (P = .13). Furthermore, pre-transplant PVT was associated with higher occurrence of post-transplant PVT (OR 5.06, 95% CI 3.89-6.57). Waitlist mortality was not significantly increased in patients with pre-transplant PVT.
Conclusion: Graft failure, mortality, and post-operative PVT are more common in pre-transplant PVT patients, especially in grade 3 or 4 PVT. Prophylactic anticoagulation can be considered to reduce re-thrombosis and improve survival.
(© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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