Portal ven Trombozunun Karaciğer Nakli Sonuçları Üzerindeki Etkisi

Portal ven trombozu (PVT), karaciğer transplantasyonu bekleyen hastaların %17,9 kadarında görülür. Bu durum, karaciğer nakli sonrası sağkalımı olumsuz etkileyebilir. Ocak 2020-Haziran 2021 tarihleri arasında nakil merkezimizde gerçekleştirilen karaciğer nakli ameliyatları tarandı. Veriler geriye dönük olarak elektronik dosya sisteminden toplandı. Alıcının cinsiyeti, yaşı, nakil endikasyonu, hepatosellüler karsinom varlığı, rejeksiyon atakları, yoğun bakım ünitesinde geçirilen gün sayısı, hastanede kalış süresi, komplikasyonlar, mortalite nedenleri ve ilgili risk faktörleri kaydedildi. PVT olmayan hastalar kontrol grubunu oluşturdu. PVT'li hastalar çalışma grubu olarak kabul edildi. Çalışma grupları arasındaki farkın anlamlılığını değerlendirmek için Student t-testi ve Mann-Whitney U testi kullanıldı. Toplamda, çalışma süresi içinde 223 karaciğer nakli gerçekleştirildi. Yeniden nakil olan 3 hasta çalışmadan çıkarıldı. 220 karaciğer nakli hastası üzerinde yapılan analizler hastaların %18,2'sinin (n=20) karaciğer nakli öncesinde PVT pozitif olduğunu gösterdi. PVT'li hastalar, daha yüksek non-alkolik steatohepatit oranına sahipti. Ek olarak, PVT varlığının cerrahi mortaliteyi ve erken rejeksiyon oranlarını önemli ölçüde arttırdığı gözlendi. Bununla bağlantılı olarak PVT'li hasta grubunda yoğun bakımda kalış süresi daha uzundu. Karaciğer nakli sonrası cerrahi mortalite PVT'li grupta daha yüksek olmasına rağmen, bu çalışmada altta yatan nedenler tespit edilmemiştir. Bununla birlikte, karaciğer transplantasyonunu takiben PVT'li hastalarda geç mortalite oranları daha yüksek değildi.

Anahtar Kelimeler:

Portal, Ven, Tromboz, Karaciğer, Transplantasyon, Sonuç

Impact of Portal Vein Thrombosis on the Outcomes of Liver Transplantation

Portal vein thrombosis (PVT) occurs in up to 17.9% of patients awaiting liver transplantation. It may impact post-liver transplantation survival negatively. The liver transplant procedures performed in our transplant center between January 2020 and June 2021 were screened. Data were collected retrospectively from the electronic folder system. Data, including causes of mortality, recipient gender, age, transplant indication, presence of hepatocellular carcinoma, rejection episodes, number of days in the intensive care unit, hospitalization duration, and complications, were recorded. Patients with no PVT constituted the control group. Patients with PVT were considered as the study group. Student’s t-test and the Mann-Whitney U test were used to evaluate the significance of the difference between study groups. Overall, 223 liver transplants were performed within the study period. Three re-transplants were excluded from the study. The analysis of 220 liver transplant patients revealed that 18.2% (n=20) of the patients presented with a PVT before liver transplantation. Patients with PVT had a higher rate of non-alcoholic steatohepatitis as an indication of a liver transplant. In addition, the presence of PVT significantly increased surgical mortality and early rejection rates. In correlation with this, the intensive care unit stay was longer in the patient group with PVT. Although the early surgical mortality post-liver transplant was higher in the group with PVT, the underlying variables could not be identified in this study. Nevertheless, the late mortality rates were not higher in patients with PVT following liver transplantation

Keywords:

Portal, Vein, Thrombosis, Liver, Transplantation, Outcome,

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