ATC Abstracts

American Transplant Congress abstracts

  • Home
  • Meetings Archive
    • 2020 American Transplant Congress
    • 2019 American Transplant Congress
    • 2018 American Transplant Congress
    • 2017 American Transplant Congress
    • 2016 American Transplant Congress
    • 2015 American Transplant Congress
    • 2013 American Transplant Congress
  • Keyword Index
  • Resources
    • 2016 Resources
      • 2016 Welcome Letter
      • ATC 2016 Program Planning Committees
      • ASTS Council 2015-2016
      • AST Board of Directors 2015-2016
    • 2015 Resources
      • 2015 Welcome Letter
      • ATC 2015 Program Planning Committees
      • ASTS Council 2014-2015
      • AST Board of Directors 2014-2015
      • 2015 Conference Schedule
  • Advanced Search

Portal Vein Thrombosis Discovered at Liver Transplant: Barrier to Success

J. Seltman1, M. Kazimi2, J. Duque3, R. Cross2, A. Ray2, T. Ommert2, R. A. Rubin2

1Mercer University Medical School, Macon, GA, 2Transplantation, Piedmont Transplant Institute, Atlanta, GA, 3Piedmont Heart Institute, Atlanta, GA

Meeting: 2019 American Transplant Congress

Abstract number: A318

Keywords: Liver transplantation, Outcome, Portal veins, Surgical complications

Session Information

Date: Saturday, June 1, 2019

Session Name: Poster Session A: Liver: Recipient Selection

Session Time: 5:30pm-7:30pm

 Presentation Time: 5:30pm-7:30pm

Location: Hall C & D

Related Abstracts
  • Surgical Technique and Outcomes of Portal Vein Reconstruction of Adult-to-Adult Living Donor Liver Transplantation Recipients with Portal Vein Thrombosis
  • Large Series Of Liver Transplantation In Patients With Portal Vein Thrombosis

*Purpose: Portal vein thrombosis (PVT) present at listing or diagnosed while listed enables potential treatment pre-liver transplant (OLT). Main PVT at OLT (mPVT) complicates surgeries and diminishes outcomes. PVT discovered at transplant (dPVT) may be more problematic. The purpose of this study was to define predictors of dPVT and to assess the impact of dPVT on outcomes.

*Methods: Single center retrospective review of clinical data in all patients with OLT 1/1/15-7/29/17. Univariate and multivariate analyses compared patients with dPVT vs. without mPVT.

*Results: 266 patients had OLT. 30 (11.3%) patients had PVT; 6 with PVT before but not at OLT and 1 with new PVT after OLT were excluded. 23 patients had mPVT; 12 known before and confirmed at OLT and 11 dPVT. There were no statistically significant associations between predictor variables (sex, age, race, BMI, cancer, NASH primary indication, diabetes mellitus, pre-OLT MELD-Na, INR or platelets) and dPVT. BMI < 18.5 kg/m2and longer time between imaging and OLT had a higher probability of dPVT in multivariate analyses. 0/11 with dPVT vs. 47/236 (20.0%) without mPVT had TIPS. 7/11 with dPVT had contrast CT or MR < 4 months before OLT; 5/11 had doppler US 12±2.7 days before OLT with portal vein velocity 20± 7.1cm/s. 1/11 with dPVT was on pre-OLT ASA. 9/11 with dPVT had thrombectomy at OLT.

Outcome No mPVT (n=236) dPVT (n=11) p VALUE
Surgical
Warm ischemia (minutes) 32.47±20.04 39.55±7.83 <0.01
Total ischemia (minutes) 329.5±101.30 412.70±121.10 0.34
FFP (U) 3.02±3.20 9.36±10.89 <0.01
RBC (U) 3.43±3.64 8.82±11.67 <0.01
Cell saver (L) 0.89±1.48 2.01±3.27 <0.01
Overall
1-year survival 93.6% 72.7% 0.04

There were 0 biliary leaks and 3 take backs with dPVT. After OLT, 8 got ASA (1 also warfarin), 10 SQ heparin, 1 no anti-coagulant. 3 had bleeding (2 intra-abdominal, 1 transfusion for anemia). 2 died during the transplant admission. 7 with dPVT were on ASA (1 also warfarin) 30 days after OLT. None had recurrent PVT after OLT.

*Conclusions: 4.1% of transplants had dPVT despite robust radiologic monitoring. Low portal vein velocities presaged dPVT in a few patients. Low BMI and longer interval between imaging and OLT were associated with dPVT. No other predictors of dPVT were identified, perhaps due to sample size. dPVT was associated with longer warm and total ischemic times, take backs, and worse survival. Larger studies are needed to define whether more aggressive pre-operative surveillance and treatment of PVT would reduce mPVT and dPVT and improve outcomes.

  • Tweet
  • Email
  • Print

To cite this abstract in AMA style:

Seltman J, Kazimi M, Duque J, Cross R, Ray A, Ommert T, Rubin RA. Portal Vein Thrombosis Discovered at Liver Transplant: Barrier to Success [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/portal-vein-thrombosis-discovered-at-liver-transplant-barrier-to-success/. Accessed March 8, 2021.

« Back to 2019 American Transplant Congress

Most Viewed Abstracts

  • This Week
  • This Month
  • All Time
  • Subtherapeutic Low Tacrolimus Trough Levels (≤3.5 Ng /ml) Are A Risk Factor For Acute Rejection And Creatinine Doubling.
  • Low GFR after Kidney Donation Is Not Chronic Kidney Disease
  • Penis Transplantation: First U.S. Experience.
  • Is There a Difference Between DCD and DBD Kidney Transplantation with Similar KDPI?
  • Live Related Kidney Transplant Experience in Abuja, Nigeria – First Eight Cases Ever.
  • Low GFR after Kidney Donation Is Not Chronic Kidney Disease
  • Subtherapeutic Low Tacrolimus Trough Levels (≤3.5 Ng /ml) Are A Risk Factor For Acute Rejection And Creatinine Doubling.
  • Penis Transplantation: First U.S. Experience.
  • Is There a Difference Between DCD and DBD Kidney Transplantation with Similar KDPI?
  • A Decade of Donor-Derived Disease: A Report of the OPTN Ad Hoc Disease Transmission Advisory Committee (DTAC).
  • Penis Transplantation: First U.S. Experience.
  • Is There a Difference Between DCD and DBD Kidney Transplantation with Similar KDPI?
  • Low GFR after Kidney Donation Is Not Chronic Kidney Disease
  • Evidence of a Clinically Significant Drug-Drug Interaction between Cannabidiol and Tacrolimus: A Case Report
  • Kidney Dialysis after Heart Transplantation: The Short and Long Term Outcomes

Visit Our Partner Sites

American Transplant Congress (ATC)

Visit the official site for the American Transplant Congress »

American Journal of Transplantation

The official publication for the American Society of Transplantation (AST) and the American Society of Transplant Surgeons (ASTS) »

American Society of Transplantation (AST)

An organization of more than 3000 professionals dedicated to advancing the field of transplantation. »

American Society of Transplant Surgeons (ASTS)

The society represents approximately 1,800 professionals dedicated to excellence in transplantation surgery. »

Copyright © 2013-2021 by American Society of Transplantation and the American Society of Transplant Surgeons. All rights reserved.

Privacy Policy

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.