Living Donor Liver Transplantation to Patients With Portal Vein Thrombosis

Study Overview
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Brief Summary
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Data of demographic, clinical, laboratory and imaging studies of living donor liver transplantation (LDLT) recipients from two transplant centers were collected. Survival and morbidity rates between patients with and without portal vein thrombosis (PVT) were compared. Risk factors of mortality in the setting of PVT were identified. Intraoperative portal flow measurements were compared before and after portal flow restoration.

Detailed Description
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LDLTs performed in two experienced centers (Ankara University Ibn-i Sina Hospital and Ankara Güven Hospital) between January 2013 and February 2020 were evaluated and included in the cohort study. Deceased donor liver transplants and pediatric transplants (deceased or living) were excluded from the study. Data relating to this study including patient history, preoperative laboratory and imaging test results, reports of surgical procedures or interventions, intraoperative anesthesia records, post-operative laboratory trends, and postoperative complications were extracted from the computer-based data management system and prospectively maintained in transplant databases in both centers. Recipients of LDLT were divided in two groups according to the presence or absence of PVT. Portal flow measurements were recorded with VeriQ (Medistim ASA, Oslo, Norway) Doppler flowmeter device in one of the centers later in the study period. The follow-up and recordings of the patients were maintained in the outpatient clinics of the two centers. The most serious complication experienced by each patient was recorded according to the Clavien-Dindo classification Primary outcome of the current study was the survival rates of patients with and without PVT Secondary outcomes of the study included morbidity in patients with and without PVT after LDLT, risk factors of mortality after LDLT to patients with PVT and comparison of intraoperative portal flow measurements between patients with and without PVT

Official Title
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Outcomes of Surgical Strategies for Living Donor Liver Transplantation to Patients With Portal Vein Thrombosis

Conditions
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Portal Vein Thrombosis, Liver Transplant; Complications

Intervention / Treatment
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* Procedure: living donor liver transplantation
* Procedure: Thrombectomy or interposition graft


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients underwent liver transplantation Exclusion Criteria: Pediatric liver transplants Deceased donor liver transplants

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| PVT<br>Patients with pretransplant portal vein thrombosis | Procedure: living donor liver transplantation<br>* Living donor liver transplantation<br>Procedure: Thrombectomy or interposition graft<br>* Portal flow restoration due to PVT in any manner<br>|
| non-PVT<br>Patients without pretransplant portal vein thrombosis | Procedure: living donor liver transplantation<br>* Living donor liver transplantation<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Survival | Posttransplant survival time | Time (days) from post transplant day1 to post transplant1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Complications | Highest grade of complication after LDLT according to Dindo-Clavien Classification | From posttransplant day1 to post-transplant 30th day | 
| Flow | Intraoperative portal flow measurements (ml/min) of diseased liver and transplanted liver with Doppler flowmeter | Intraoperatively twice: before recipient hepatectomy (portal flow of diseased liver ) and at the end of transplantation procedure | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Liver transplantation, Portal vein thrombosis, Thrombectomy, Doppler flowmeter