Donor tobacco smoking is associated with postoperative thrombosis after primary liver transplantation
| Autor: | Vincent E de Meijer, Michiel Voskuil, Eleonora A. M. Festen, Hans Blokzijl, Lianne M Nieuwenhuis, Maureen J M Werner, Rinse K. Weersma, Yanni Li, Ton Lisman, Robert J. Porte, Ranko Gacesa |
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| Přispěvatelé: | Groningen Institute for Organ Transplantation (GIOT), Groningen Institute for Gastro Intestinal Genetics and Immunology (3GI), Center for Liver, Digestive and Metabolic Diseases (CLDM) |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment CYTOMEGALOVIRUS graft survival 030204 cardiovascular system & hematology Liver transplantation 03 medical and health sciences 0302 clinical medicine Hepatic Artery Postoperative Complications Internal medicine Post-hoc analysis medicine Tobacco Smoking MANAGEMENT Humans hepatic artery thrombosis risk factors HEPATIC-ARTERY THROMBOSIS portal vein thrombosis Retrospective Studies COMPLICATIONS liver transplantation business.industry Hazard ratio Thrombosis Hematology Odds ratio Original Articles medicine.disease Portal vein thrombosis Transplantation PORTAL-VEIN THROMBOSIS EXPERIENCE Original Article business Cohort study |
| Zdroj: | Journal of Thrombosis and Haemostasis, 18(10), 2590-2600. Wiley Journal of Thrombosis and Haemostasis |
| ISSN: | 1538-7836 1538-7933 |
| DOI: | 10.1111/jth.14983 |
| Popis: | Background: Thrombosis after liver transplantation is a leading cause of graft loss, morbidity, and mortality. Several known recipient- and surgery-related characteristics have been associated with increased risk of thrombosis after transplantation. Potential donor-related risk factors, however, remain largely undefined. Objectives: We aimed to identify risk factors for early post-transplantation thrombosis ('90 days) and to determine the impact of early postoperative thrombosis on long-term graft and patient survival. Patients/Methods: A post hoc analysis was performed of an observational cohort study including all primary, adult liver transplantations performed between 1993 and 2018. Donor-, recipient-, and surgery-related characteristics were collected. Competing risk model analyses and multivariable regression analyses were performed to identify risk factors for developing early post-transplant thrombosis and graft failure. Results: From a total of 748 adult liver transplantations, 58 recipients (7.8%) developed a thrombosis after a median of 7 days. Post-transplantation thrombotic events included 25 hepatic artery thromboses, 13 portal vein thromboses, and 22 other thrombotic complications. Donor history of smoking was independently associated with early postoperative thrombosis (odds ratio [OR] 2.42; 95% confidence interval [CI], 1.29-4.52). Development of early post-transplant thrombosis was independently associated with patient mortality (hazard ratio [HR] 3.61; 95% CI 1.54-8.46) and graft failure (HR 5.80, 95% CI 3.26-10.33), respectively. Conclusion: Donor history of smoking conveys a more than two-fold increased risk of thrombosis after liver transplantation, independent of other factors. Post-transplant thrombosis was independently associated with decreased patient and graft survival. |
| Databáze: | OpenAIRE |
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