TY - JOUR
T1 - Therapeutic anticoagulation after liver transplantation is not useful among patients with pre-transplant Yerdel-grade I/II portal vein thrombosis
T2 - A two-center retrospective study
AU - Bos, Isabel
AU - Blondeau, Marc
AU - Wouters, Dune
AU - Camus, Christophe
AU - Houssel-Debry, Pauline
AU - van der Plas, Willemijn S.
AU - Nieuwenhuis, Lianne M.
AU - Bardou-Jacquet, Edouard
AU - Lisman, Ton
AU - de Meijer, Vincent E.
AU - Porte, Robert J.
AU - Rayar, Michel
N1 - Publisher Copyright:
© 2021 International Society on Thrombosis and Haemostasis
PY - 2021/11
Y1 - 2021/11
N2 - Background: Portal vein thrombosis (PVT) is no longer a contraindication for liver transplantation (LT). While therapeutic anticoagulation (tAC) is recommended during the waiting period, there is no evidence for its usefulness in the prevention of PVT recurrence after LT. Objectives: The aim of our study was to evaluate the role of tAC post-LT in the prevention of PVT recurrence. Patients/methods: All adult LTs performed in two high-volume centers between 2003 and 2018 were retrospectively analysed. Only patients with PVT classified as Yerdel grade I or II and with standard portal reconstruction were included. PVT recurrence and tAC-associated morbidity within 1 year were compared between patients receiving tAC or not. Results: During the study period, of 2612 LTs performed, 235 (9%) patients with PVT were included; 113 patients (48.1%) received post-LT tAC (tAC group) while 122 (51.9%) did not (non-tAC group). The incidence of bleeding events was significantly higher in the tAC group (26 [23%] vs. 5 [4.1%], P <.01) and the initial hospitalization duration was longer (21 vs. 17.5 days, P <.01). Within the first year, PVT recurrence was observed for 9 (3.8%) patients without any difference between the tAC and non-tAC groups (6 [5.1%] vs. 3 [2.5%], P =.39). The only identified risk factor for PVT recurrence was the recipients’ age (odds ratio= 0.94, P =.03). Graft (P =.11) and patient (P =.44) survival were similar between the two groups. Conclusion: Therapeutic anticoagulation is not necessary in the prevention of grade I/II PVT recurrence and is associated with higher morbidity and longer hospital stay.
AB - Background: Portal vein thrombosis (PVT) is no longer a contraindication for liver transplantation (LT). While therapeutic anticoagulation (tAC) is recommended during the waiting period, there is no evidence for its usefulness in the prevention of PVT recurrence after LT. Objectives: The aim of our study was to evaluate the role of tAC post-LT in the prevention of PVT recurrence. Patients/methods: All adult LTs performed in two high-volume centers between 2003 and 2018 were retrospectively analysed. Only patients with PVT classified as Yerdel grade I or II and with standard portal reconstruction were included. PVT recurrence and tAC-associated morbidity within 1 year were compared between patients receiving tAC or not. Results: During the study period, of 2612 LTs performed, 235 (9%) patients with PVT were included; 113 patients (48.1%) received post-LT tAC (tAC group) while 122 (51.9%) did not (non-tAC group). The incidence of bleeding events was significantly higher in the tAC group (26 [23%] vs. 5 [4.1%], P <.01) and the initial hospitalization duration was longer (21 vs. 17.5 days, P <.01). Within the first year, PVT recurrence was observed for 9 (3.8%) patients without any difference between the tAC and non-tAC groups (6 [5.1%] vs. 3 [2.5%], P =.39). The only identified risk factor for PVT recurrence was the recipients’ age (odds ratio= 0.94, P =.03). Graft (P =.11) and patient (P =.44) survival were similar between the two groups. Conclusion: Therapeutic anticoagulation is not necessary in the prevention of grade I/II PVT recurrence and is associated with higher morbidity and longer hospital stay.
UR - http://www.scopus.com/inward/record.url?scp=85111815795&partnerID=8YFLogxK
U2 - 10.1111/jth.15472
DO - 10.1111/jth.15472
M3 - Article
C2 - 34297481
AN - SCOPUS:85111815795
SN - 1538-7933
VL - 19
SP - 2760
EP - 2771
JO - Journal of Thrombosis and Haemostasis
JF - Journal of Thrombosis and Haemostasis
IS - 11
ER -