Background: The prevalence of Portal Vein Thrombosis (PVT) in cirrhotic liver transplant patients increases the risk of morbidity and mortality post-liver transplantation. Current research suggests that PVT should be managed with anticoagulation in those with cirrhosis that are waiting for liver transplant. Anticoagulation therapy and management is not uniformly practiced in pre-liver transplant patients with cirrhosis and PVT, nor are there established clinical guidelines.

The purpose of this study was to compare the outcomes in mortality following liver transplant in patients from the University of Wisconsin who had PVT prior to transplantation and were, or were not treated with anticoagulation.

Methods: This was a single-institution, retrospective review from a prospectively collected database to evaluate the utility of anticoagulation therapy in patients with PVT that underwent liver transplantation between January 1, 2006 and June 30, 2014. The primary outcome of interest was patient mortality. Patients were excluded as a result of additional diagnoses including atrial fibrillation, cerebral vascular accident, pulmonary emboli and deep vein thrombosis.

Results: From a total of 755 liver transplants performed between January 1, 2006 and June 30, 2014, 56 patients with PVT were evaluated in this study(Table 1). There was no statistically significant difference in mortality between the 4 groups in table 1 (p = 0.67).

Conclusion: This study suggests the use of anticoagulation and thrombectomy at liver transplant may improve the mortality outcomes in this population (Table 1). The results are not statistically significant, likely due to the small sample size.

A multi-center study of the same design would be of benefit to improve the power of the data and better evaluate the use of anticoagulation therapy in the liver transplant patient with PVT. Review of this data in 2 years would allow us to continue to further evaluate morbidity and mortality in this patient cohort.

CITATION INFORMATION: Falls M, Said A, Fernandez L, Foley D, Frith K, Hager D, Hoy H, Leverson G, Mezrich J, Prickette T, Wakefield M, D'Alessandro A. Outcomes of Anticoagulation Use for Portal Vein Thrombosis in University of Wisconsin Liver Transplant Patients. Am J Transplant. 2016;16 (suppl 3).

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