Long term outcomes and complications of reno‐portal anastomosis in liver transplantation: results from a propensity score‐based outcome analysis
| Autor: | Sherif Armanyous, Hajime Matsushima, Federico Aucejo, Luca Del Prete, Koji Hashimoto, Giuseppe D’Amico, Masato Fujiki, Choon Hyuck David Kwon, Charles Miller, Bijan Eghtesad, Andrea Simioni, Kazunari Sasaki, Cristiano Quintini, Teresa Diago Uso |
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| Rok vydání: | 2021 |
| Předmět: |
Transplantation
medicine.medical_specialty Portal Vein business.industry medicine.medical_treatment Incidence (epidemiology) Anastomosis Surgical Renal function Anastomosis Liver transplantation Kidney medicine.disease Thrombosis Liver Transplantation Surgery Portal vein thrombosis Splanchnic vein thrombosis Propensity score matching medicine Humans Propensity Score business Retrospective Studies |
| Zdroj: | Transplant International. 34:1938-1947 |
| ISSN: | 1432-2277 0934-0874 |
| Popis: | Introduction Diffuse splanchnic vein thrombosis (DSVT) remains a serious challenge in liver transplantation (LT). Reno-portal anastomosis (RPA) has previously been reported as a valid option for management of patients with DSVT during LT. The aim of this study was to evaluate posttransplant renal function and surgical outcomes of patients with DSVT who underwent RPA during LT. Methods Between January 2005 and December 2017, 1,270 patients underwent LT at our institution, including 16 with DSVT managed with RPA (RPA group). We compared renal function and surgical outcomes in these patients to outcomes in 48 propensity-score (PS) matched patients without thrombosis (control group), using a 1:3 matching model. Results The two groups had similar rates of postoperative portal vein thrombosis (PVT), renal dysfunction as measured by estimated glomerular filtration rate (eGFR), and overall postoperative complications (Clavien grade III), although the RPA group had a higher incidence of postoperative upper gastrointestinal (GI) bleeding (31.3% vs 4.2%; p=0.009) that had no clinical consequence. There were no significant differences in five-year graft and patient survival rates between the groups (p=0.133 and p=0.166, respectively). Conclusion RPA is an established technique in the management of patients with DSVT during LT, with comparable outcomes to patients without thrombosis. Our report is the first to demonstrate similar surgical outcomes, including long-term renal function, in LT recipients with or without RPA. |
| Databáze: | OpenAIRE |
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