Liver transplant recipients with portal vein thrombosis receiving an organ from a high-risk donor are at an increased risk for graft loss due to hepatic artery thrombosis

Jonathan G. Stine, Curtis K. Argo, Shawn J. Pelletier, Daniel Maluf, Patrick G. Northup

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

We hypothesize that recipients with pretransplant portal vein thrombosis (PVT) receiving organs from high-risk donors (HRD) are at an increased risk of HAT. Data on all liver transplants in the United States from February 2002 to March 2015 were analyzed. Recipients were sorted into two groups: those with PVT and those without. HRDs were defined by donor risk index (DRI) >1.7. Multivariable logistic regression models were constructed to assess the independent risk factors for HAT with the resultant graft loss ≤90 days from transplantation. A total of 60 404 candidates underwent liver transplantation; of those recipients, 623 (1.0%) had HAT, of which 66.0% (n = 411) received organs from HRDs compared with 49.3% (n = 29 473) in recipients without HAT (P < 0.001); 2250 (3.7%) recipients had pretransplantation PVT and received organs from HRDs. On adjusted multivariable analysis, PVT with a HRD organ was the most significant independent risk factor (OR 3.56, 95% CI 2.52–5.02, P < 0.001) for the development of HAT. Candidates with pretransplant PVT who receive an organ from a HRD are at the highest risk for postoperative HAT independent of other measurable factors. Recipients with pretransplant PVT would benefit from careful donor selection and possibly anticoagulation perioperatively.

Original languageEnglish (US)
Pages (from-to)1286-1295
Number of pages10
JournalTransplant International
Volume29
Issue number12
DOIs
StatePublished - Dec 1 2016

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Hepatic Artery
Portal Vein
Thrombosis
Tissue Donors
Transplants
Liver
Logistic Models
Donor Selection
Liver Transplantation
Transplant Recipients
Transplantation

All Science Journal Classification (ASJC) codes

  • Transplantation

Cite this

Liver transplant recipients with portal vein thrombosis receiving an organ from a high-risk donor are at an increased risk for graft loss due to hepatic artery thrombosis. / Stine, Jonathan G.; Argo, Curtis K.; Pelletier, Shawn J.; Maluf, Daniel; Northup, Patrick G.

In: Transplant International, Vol. 29, No. 12, 01.12.2016, p. 1286-1295.

Research output: Contribution to journalArticle

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abstract = "We hypothesize that recipients with pretransplant portal vein thrombosis (PVT) receiving organs from high-risk donors (HRD) are at an increased risk of HAT. Data on all liver transplants in the United States from February 2002 to March 2015 were analyzed. Recipients were sorted into two groups: those with PVT and those without. HRDs were defined by donor risk index (DRI) >1.7. Multivariable logistic regression models were constructed to assess the independent risk factors for HAT with the resultant graft loss ≤90 days from transplantation. A total of 60 404 candidates underwent liver transplantation; of those recipients, 623 (1.0{\%}) had HAT, of which 66.0{\%} (n = 411) received organs from HRDs compared with 49.3{\%} (n = 29 473) in recipients without HAT (P < 0.001); 2250 (3.7{\%}) recipients had pretransplantation PVT and received organs from HRDs. On adjusted multivariable analysis, PVT with a HRD organ was the most significant independent risk factor (OR 3.56, 95{\%} CI 2.52–5.02, P < 0.001) for the development of HAT. Candidates with pretransplant PVT who receive an organ from a HRD are at the highest risk for postoperative HAT independent of other measurable factors. Recipients with pretransplant PVT would benefit from careful donor selection and possibly anticoagulation perioperatively.",
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