P-26 PORTAL VENOUS THROMBOSIS IN TRANSPLANTED CIRRHOTIC PATIENTS AT THE “HOSPITAL CLÍNICO UNIVERSIDAD DE CHILE”

Abstract

Background: Portal vein thrombosis (PVT) is a frequent complication in cirrhotic patients on the waiting list for liver transplantation (LT); this is associated with increased post-LT mortality. Objective: Characterize the presence of PVT in patients with LT. Methods: Retrospective observational study between January 1, 2014 and February 28, 2018. Clinical records, laboratory and images were reviewed. Results: 82 patients were included; Age 58 (21-71) years; Etiology: non-alcoholic fatty liver 40.2%, alcoholic liver disease 20.7%, autoimmunity 13.4%, and hepatitis C 8.5%; Child-Pugh: 7.3% A, 30.4% B and 62.2% C; MELD-Na 22 (8-40). PVT was diagnosed before or during LT in 26.8%: Child A 16.6%, B 16.0%, and C 33.3%; MELD-Na 25 (12-40) in those with PVT vs 21 (8-40) in those without PVT (non significant, NS); 34% had hepatocarcinoma (32.1% with PVT vs. 24.4% without PVT; NS). Diagnosis of PVT was 77.2% pre LT and almost 1/4 during transplant surgery. The extension of the PVT was complete occlusion in 11.7%, partial in 70.5%; 11.7% had only intrahepatic branches compromised (1 case with incomplete data). In 76% of the patients anticoagulation (AC) was started during waiting list; none had complications associated to AC. Complete re-canalization was achieved in 53.8%. The 5-year survival was 70%; 71.7% in those without PVT and 63.6% in those with PVT (NS). Conclusion: PVT is a frequent complication in cirrhotic patients in the waiting list who received LT. Most receive AC without complications. The 5-year survival in this series was similar despite the presence of PVT.Selected subject area: Liver Transplantation.