Impact of Nonmalignant Portal Vein Thrombosis in Transplant Recipients With Nonalcoholic Steatohepatitis

Uchenna Agbim, Yu Jiang, Satish K. Kedia, Ashwani K. Singal, Aijaz Ahmed, Kalyan Ram Bhamidimarri, David E. Bernstein, Stephen A. Harrison, Zobair M. Younossi, Sanjaya Satapathy

Research output: Contribution to journalArticle

Abstract

Nonalcoholic fatty liver disease is an increasingly prevalent condition, and its more severe progressive state, nonalcoholic steatohepatitis (NASH), is currently the second most common indication for wait-listed adults in the United States. The association of portal vein thrombosis (PVT) prior to or at transplant and poor graft and patient outcomes is not well established, particularly among NASH patients who inherently have an increased hypercoagulable profile. Using the United Network for Organ Sharing data set, we analyzed graft and patient outcomes of patients transplanted for the indication of NASH with and without PVT. Of 3689 NASH transplant recipients, the prevalence of PVT was 12% (450 with PVT and 3239 without PVT). NASH transplant recipients with PVT had inferior graft and patient survival compared with NASH transplant recipients without PVT, even after adjusting for recipient and donor demographic characteristics, body mass index, synthetic dysfunction, and presence of diabetes. In a multivariate Cox regression model, NASH transplant recipients with PVT had a 37% increased risk of graft failure (hazard ratio [HR], 1.37; 95% confidence interval [CI], 1.15-1.63; P < 0.001) and 31% increased risk of overall death (HR, 1.31; 95% CI, 1.09-1.58; P < 0.001) compared with NASH transplant recipients without PVT at transplant. This difference in graft and patient survival was most pronounced in the early posttransplant period. These results demonstrate that NASH patients with PVT have decreased graft and patient survival independent of recipient and donor factors.

Original languageEnglish (US)
Pages (from-to)68-78
Number of pages11
JournalLiver Transplantation
Volume25
Issue number1
DOIs
StatePublished - Jan 1 2019

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Portal Vein
Thrombosis
Transplants
Graft Survival
Transplant Recipients
Non-alcoholic Fatty Liver Disease
Tissue Donors
Confidence Intervals
Proportional Hazards Models
Body Mass Index
Demography

All Science Journal Classification (ASJC) codes

  • Surgery
  • Hepatology
  • Transplantation

Cite this

Impact of Nonmalignant Portal Vein Thrombosis in Transplant Recipients With Nonalcoholic Steatohepatitis. / Agbim, Uchenna; Jiang, Yu; Kedia, Satish K.; Singal, Ashwani K.; Ahmed, Aijaz; Bhamidimarri, Kalyan Ram; Bernstein, David E.; Harrison, Stephen A.; Younossi, Zobair M.; Satapathy, Sanjaya.

In: Liver Transplantation, Vol. 25, No. 1, 01.01.2019, p. 68-78.

Research output: Contribution to journalArticle

Agbim, U, Jiang, Y, Kedia, SK, Singal, AK, Ahmed, A, Bhamidimarri, KR, Bernstein, DE, Harrison, SA, Younossi, ZM & Satapathy, S 2019, 'Impact of Nonmalignant Portal Vein Thrombosis in Transplant Recipients With Nonalcoholic Steatohepatitis' Liver Transplantation, vol. 25, no. 1, pp. 68-78. https://doi.org/10.1002/lt.25322
Agbim, Uchenna ; Jiang, Yu ; Kedia, Satish K. ; Singal, Ashwani K. ; Ahmed, Aijaz ; Bhamidimarri, Kalyan Ram ; Bernstein, David E. ; Harrison, Stephen A. ; Younossi, Zobair M. ; Satapathy, Sanjaya. / Impact of Nonmalignant Portal Vein Thrombosis in Transplant Recipients With Nonalcoholic Steatohepatitis. In: Liver Transplantation. 2019 ; Vol. 25, No. 1. pp. 68-78.
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