Protein S Deficiency as an Independent Risk Factor for Portal Vein Thrombosis in Cirrhotic Patients Awaiting Liver Transplantation
1Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan, Taiwan
2Division of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan, Taiwan.
Meeting: 2018 American Transplant Congress
Abstract number: C236
Keywords: High-risk, Liver cirrhosis
Session Information
Session Name: Poster Session C: Liver: Recipient Selection
Session Type: Poster Session
Date: Monday, June 4, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Background:
Portal vein thrombosis (PVT) in cirrhotic patients not only induces lethal complications on waiting, but also complicates surgical procedures and increases risk during transplantation. The mechanism of development of PVT in cirrhotic patients with coagulopathy is unclear. This study aimed to identify possible risk factors to predict PVT in cirrhotic patients.
Materials and Methods:
From January 2013 to December 2015, a total of 352 cirrhotic patients who were awaiting liver transplantation in our institute were included for a retrospective cohort study. PVT was defined by either radiological evaluation or intraoperative confirmation (n=166, 47.2%) of the presence of portal thrombosis and the surgical evidence took precedence over the radiological suspicion in the condition of distinct results. We have assessed the correlation of the development of portal vein thrombosis (PVT, n=51) and the opposite group (non-PVT, n=301) with clinicopathologic features by Pearson's chi-squared test and univariate and multivariate analyses were carried out to identify independent prognostic factors. The demarcated point of categorized parameter was set according to laboratory reference.
Results:
Over 3-year observation, the mean age of our population was 53.2 year-old, and the majority of gender was male in a percentage of 75.9%. There were over 70% patients with either hepatitis B or C infection, and nearly 40% associated with liver malignancy. The average MELD score was 16.2. In general, INR prolongation, thrombocytopenia and relative deficiency of protein C and protein S level were observed. A significant correlation in patterns of decreased PLT and deficiency of protein C and protein S was associated with PVT group. Multivariate analysis demonstrated low protein S level (P= 0.035, HR= 2.21, 95% CI= 1.06-4.60) as the only independent risk for PVT development.
Conclusion:
In conclusion, the serum coagulation and anti-coagulation factors are easily available information. PVT patients displayed a decreased serum PLT, Protein C and S levels. The development of PVT in these cirrhotic patients was associated with protein S deficiency independently.
CITATION INFORMATION: Hung H-.C., Lee J-.C., Cheng C-.H., Wang Y-.C., Wu T-.H., Lee C-.F., Wu T-.J., Chou H., Chan K-.M., Lee W-.C. Protein S Deficiency as an Independent Risk Factor for Portal Vein Thrombosis in Cirrhotic Patients Awaiting Liver Transplantation Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Hung H-C, Lee J-C, Cheng C-H, Wang Y-C, Wu T-H, Lee C-F, Wu T-J, Chou H, Chan K-M, Lee W-C. Protein S Deficiency as an Independent Risk Factor for Portal Vein Thrombosis in Cirrhotic Patients Awaiting Liver Transplantation [abstract]. https://atcmeetingabstracts.com/abstract/protein-s-deficiency-as-an-independent-risk-factor-for-portal-vein-thrombosis-in-cirrhotic-patients-awaiting-liver-transplantation/. Accessed May 16, 2025.« Back to 2018 American Transplant Congress