Portal Vein Complications After Adult Living Donor Liver Transplantation: Time of Onset and Deformity Patterns Affect Long‐Term Outcomes
Portal vein complications (PVCs) after adult living donor liver transplantation (LDLT) are potentially lethal. We categorized PVCs by the time of onset (early versus late,
Gespeichert in:
| Veröffentlicht in: | Liver transplantation 2021-06, Vol.27 (6), p.854-865 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 865 |
|---|---|
| container_issue | 6 |
| container_start_page | 854 |
| container_title | Liver transplantation |
| container_volume | 27 |
| creator | Sambommatsu, Yuzuru Shimata, Keita Ibuki, Sho Narita, Yasuko Isono, Kaori Honda, Masaki Irie, Tomoaki Kadohisa, Masashi Kawabata, Seiichi Yamamoto, Hidekazu Sugawara, Yasuhiko Ikeda, Osamu Inomata, Yukihiro Hibi, Taizo |
| description | Portal vein complications (PVCs) after adult living donor liver transplantation (LDLT) are potentially lethal. We categorized PVCs by the time of onset (early versus late, |
| doi_str_mv | 10.1002/lt.25977 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2471531534</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2471531534</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4157-32763d3c96752b2912e77d99d0108450e5c0b77fec46cc9b78ef80d3663845683</originalsourceid><addsrcrecordid>eNp1kc9rFDEUx4MotlbBv0ACXnqZmh-TZMbbstW2sLA9jF7DbOZNSckka5JR9tazJ_9G_5Kmu7WCIARewvvweS98EXpLyRklhH1w-YyJVqln6JgKpipZK_786S7FEXqV0i0hlIqWvERHnPNatkwdo5_XIebe4a9gPV6Gaeus6bMNPuHFmCHixTC7jFf2u_U3-Dz4EB8epdHF3qet633e8x9xZyfAYcRrnyDj3g_4HMYQJ5t3-LrPRbaXjmCKL_ib33e_OogTXs_ZhAnSa_Ri7F2CN4_1BH35_KlbXlar9cXVcrGqTE2FqjhTkg_ctFIJtmEtZaDU0LYDoaSpBQFhyEapMqaWxrQb1cDYkIFLyUtbNvwEnR682xi-zZCynmwy4MpXIMxJs1pRwcupC_r-H_Q2zNGX7TQTvKGUlvJXaGJIKcKot9FOfdxpSvRDPtplvc-noO8ehfNmguEJ_BNIAaoD8MM62P1XpFfdQXgPv0aZOQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2538111253</pqid></control><display><type>article</type><title>Portal Vein Complications After Adult Living Donor Liver Transplantation: Time of Onset and Deformity Patterns Affect Long‐Term Outcomes</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>Alma/SFX Local Collection</source><creator>Sambommatsu, Yuzuru ; Shimata, Keita ; Ibuki, Sho ; Narita, Yasuko ; Isono, Kaori ; Honda, Masaki ; Irie, Tomoaki ; Kadohisa, Masashi ; Kawabata, Seiichi ; Yamamoto, Hidekazu ; Sugawara, Yasuhiko ; Ikeda, Osamu ; Inomata, Yukihiro ; Hibi, Taizo</creator><creatorcontrib>Sambommatsu, Yuzuru ; Shimata, Keita ; Ibuki, Sho ; Narita, Yasuko ; Isono, Kaori ; Honda, Masaki ; Irie, Tomoaki ; Kadohisa, Masashi ; Kawabata, Seiichi ; Yamamoto, Hidekazu ; Sugawara, Yasuhiko ; Ikeda, Osamu ; Inomata, Yukihiro ; Hibi, Taizo</creatorcontrib><description>Portal vein complications (PVCs) after adult living donor liver transplantation (LDLT) are potentially lethal. We categorized PVCs by the time of onset (early versus late, <1 month versus ≥1 month, respectively) and deformity patterns (portal vein stenosis [PVS], portal vein thrombosis [PVT], and portal vein occlusion [PVO]) to establish optimal treatment strategies. Overall, 35/322 (10.9%) recipients developed PVCs between 2000 and 2019. Pretransplant PVT (odds ratio [OR], 15.20; 95% confidence interval [CI], 3.70‐62.40; P < 0.001) was the only independent risk factor for PVS. In contrast, male sex (OR, 5.57; 95% CI, 1.71‐18.20; P = 0.004), pretransplant PVT (OR, 4.79; 95% CI, 1.64‐14.00; P = 0.004), and splenectomy (OR, 3.24; 95% CI, 1.23‐8.57; P = 0.018) were independent risk factors for PVT. PVS was successfully treated with interventional radiology regardless of its time of onset. On the other hand, late PVT and PVO had significantly lower treatment success rates (2/15, 13%) compared with those that occurred in the early period (10/11, 91%) despite aggressive intervention (P < 0.001). Deformity patterns had a significant impact on the 5‐year cumulative incidence of graft loss as a result of PVC (PVO + Yerdel grades 2‐4 PVT group [n = 16], 41% versus PVS + Yerdel grade 1 PVT group [n = 19], 0%; P = 0.02). In conclusion, late grades 2 to 4 PVT and PVO are refractory to treatment and associated with poor prognoses, whereas PVS has a good prognosis regardless of time of onset. A tailored approach according to the time of onset and deformity patterns of PVC is essential.</description><identifier>ISSN: 1527-6465</identifier><identifier>EISSN: 1527-6473</identifier><identifier>DOI: 10.1002/lt.25977</identifier><identifier>PMID: 33346927</identifier><language>eng</language><publisher>United States: Wolters Kluwer Health, Inc</publisher><subject>Adult ; Humans ; Liver transplantation ; Liver Transplantation - adverse effects ; Liver transplants ; Living Donors ; Male ; Occlusion ; Portal vein ; Portal Vein - diagnostic imaging ; Prognosis ; Retrospective Studies ; Risk factors ; Splenectomy ; Stenosis ; Thrombosis ; Venous Thrombosis - diagnostic imaging ; Venous Thrombosis - epidemiology</subject><ispartof>Liver transplantation, 2021-06, Vol.27 (6), p.854-865</ispartof><rights>Copyright © 2020 by the American Association for the Study of Liver Diseases.</rights><rights>2021 by the American Association for the Study of Liver Diseases.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4157-32763d3c96752b2912e77d99d0108450e5c0b77fec46cc9b78ef80d3663845683</citedby><cites>FETCH-LOGICAL-c4157-32763d3c96752b2912e77d99d0108450e5c0b77fec46cc9b78ef80d3663845683</cites><orcidid>0000-0002-5552-5539 ; 0000-0001-7057-1544 ; 0000-0002-6867-228X ; 0000-0003-4734-5084 ; 0000-0002-6867-228</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Flt.25977$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Flt.25977$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33346927$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sambommatsu, Yuzuru</creatorcontrib><creatorcontrib>Shimata, Keita</creatorcontrib><creatorcontrib>Ibuki, Sho</creatorcontrib><creatorcontrib>Narita, Yasuko</creatorcontrib><creatorcontrib>Isono, Kaori</creatorcontrib><creatorcontrib>Honda, Masaki</creatorcontrib><creatorcontrib>Irie, Tomoaki</creatorcontrib><creatorcontrib>Kadohisa, Masashi</creatorcontrib><creatorcontrib>Kawabata, Seiichi</creatorcontrib><creatorcontrib>Yamamoto, Hidekazu</creatorcontrib><creatorcontrib>Sugawara, Yasuhiko</creatorcontrib><creatorcontrib>Ikeda, Osamu</creatorcontrib><creatorcontrib>Inomata, Yukihiro</creatorcontrib><creatorcontrib>Hibi, Taizo</creatorcontrib><title>Portal Vein Complications After Adult Living Donor Liver Transplantation: Time of Onset and Deformity Patterns Affect Long‐Term Outcomes</title><title>Liver transplantation</title><addtitle>Liver Transpl</addtitle><description>Portal vein complications (PVCs) after adult living donor liver transplantation (LDLT) are potentially lethal. We categorized PVCs by the time of onset (early versus late, <1 month versus ≥1 month, respectively) and deformity patterns (portal vein stenosis [PVS], portal vein thrombosis [PVT], and portal vein occlusion [PVO]) to establish optimal treatment strategies. Overall, 35/322 (10.9%) recipients developed PVCs between 2000 and 2019. Pretransplant PVT (odds ratio [OR], 15.20; 95% confidence interval [CI], 3.70‐62.40; P < 0.001) was the only independent risk factor for PVS. In contrast, male sex (OR, 5.57; 95% CI, 1.71‐18.20; P = 0.004), pretransplant PVT (OR, 4.79; 95% CI, 1.64‐14.00; P = 0.004), and splenectomy (OR, 3.24; 95% CI, 1.23‐8.57; P = 0.018) were independent risk factors for PVT. PVS was successfully treated with interventional radiology regardless of its time of onset. On the other hand, late PVT and PVO had significantly lower treatment success rates (2/15, 13%) compared with those that occurred in the early period (10/11, 91%) despite aggressive intervention (P < 0.001). Deformity patterns had a significant impact on the 5‐year cumulative incidence of graft loss as a result of PVC (PVO + Yerdel grades 2‐4 PVT group [n = 16], 41% versus PVS + Yerdel grade 1 PVT group [n = 19], 0%; P = 0.02). In conclusion, late grades 2 to 4 PVT and PVO are refractory to treatment and associated with poor prognoses, whereas PVS has a good prognosis regardless of time of onset. A tailored approach according to the time of onset and deformity patterns of PVC is essential.</description><subject>Adult</subject><subject>Humans</subject><subject>Liver transplantation</subject><subject>Liver Transplantation - adverse effects</subject><subject>Liver transplants</subject><subject>Living Donors</subject><subject>Male</subject><subject>Occlusion</subject><subject>Portal vein</subject><subject>Portal Vein - diagnostic imaging</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Risk factors</subject><subject>Splenectomy</subject><subject>Stenosis</subject><subject>Thrombosis</subject><subject>Venous Thrombosis - diagnostic imaging</subject><subject>Venous Thrombosis - epidemiology</subject><issn>1527-6465</issn><issn>1527-6473</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc9rFDEUx4MotlbBv0ACXnqZmh-TZMbbstW2sLA9jF7DbOZNSckka5JR9tazJ_9G_5Kmu7WCIARewvvweS98EXpLyRklhH1w-YyJVqln6JgKpipZK_786S7FEXqV0i0hlIqWvERHnPNatkwdo5_XIebe4a9gPV6Gaeus6bMNPuHFmCHixTC7jFf2u_U3-Dz4EB8epdHF3qet633e8x9xZyfAYcRrnyDj3g_4HMYQJ5t3-LrPRbaXjmCKL_ib33e_OogTXs_ZhAnSa_Ri7F2CN4_1BH35_KlbXlar9cXVcrGqTE2FqjhTkg_ctFIJtmEtZaDU0LYDoaSpBQFhyEapMqaWxrQb1cDYkIFLyUtbNvwEnR682xi-zZCynmwy4MpXIMxJs1pRwcupC_r-H_Q2zNGX7TQTvKGUlvJXaGJIKcKot9FOfdxpSvRDPtplvc-noO8ehfNmguEJ_BNIAaoD8MM62P1XpFfdQXgPv0aZOQ</recordid><startdate>202106</startdate><enddate>202106</enddate><creator>Sambommatsu, Yuzuru</creator><creator>Shimata, Keita</creator><creator>Ibuki, Sho</creator><creator>Narita, Yasuko</creator><creator>Isono, Kaori</creator><creator>Honda, Masaki</creator><creator>Irie, Tomoaki</creator><creator>Kadohisa, Masashi</creator><creator>Kawabata, Seiichi</creator><creator>Yamamoto, Hidekazu</creator><creator>Sugawara, Yasuhiko</creator><creator>Ikeda, Osamu</creator><creator>Inomata, Yukihiro</creator><creator>Hibi, Taizo</creator><general>Wolters Kluwer Health, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5552-5539</orcidid><orcidid>https://orcid.org/0000-0001-7057-1544</orcidid><orcidid>https://orcid.org/0000-0002-6867-228X</orcidid><orcidid>https://orcid.org/0000-0003-4734-5084</orcidid><orcidid>https://orcid.org/0000-0002-6867-228</orcidid></search><sort><creationdate>202106</creationdate><title>Portal Vein Complications After Adult Living Donor Liver Transplantation: Time of Onset and Deformity Patterns Affect Long‐Term Outcomes</title><author>Sambommatsu, Yuzuru ; Shimata, Keita ; Ibuki, Sho ; Narita, Yasuko ; Isono, Kaori ; Honda, Masaki ; Irie, Tomoaki ; Kadohisa, Masashi ; Kawabata, Seiichi ; Yamamoto, Hidekazu ; Sugawara, Yasuhiko ; Ikeda, Osamu ; Inomata, Yukihiro ; Hibi, Taizo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4157-32763d3c96752b2912e77d99d0108450e5c0b77fec46cc9b78ef80d3663845683</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Humans</topic><topic>Liver transplantation</topic><topic>Liver Transplantation - adverse effects</topic><topic>Liver transplants</topic><topic>Living Donors</topic><topic>Male</topic><topic>Occlusion</topic><topic>Portal vein</topic><topic>Portal Vein - diagnostic imaging</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Risk factors</topic><topic>Splenectomy</topic><topic>Stenosis</topic><topic>Thrombosis</topic><topic>Venous Thrombosis - diagnostic imaging</topic><topic>Venous Thrombosis - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sambommatsu, Yuzuru</creatorcontrib><creatorcontrib>Shimata, Keita</creatorcontrib><creatorcontrib>Ibuki, Sho</creatorcontrib><creatorcontrib>Narita, Yasuko</creatorcontrib><creatorcontrib>Isono, Kaori</creatorcontrib><creatorcontrib>Honda, Masaki</creatorcontrib><creatorcontrib>Irie, Tomoaki</creatorcontrib><creatorcontrib>Kadohisa, Masashi</creatorcontrib><creatorcontrib>Kawabata, Seiichi</creatorcontrib><creatorcontrib>Yamamoto, Hidekazu</creatorcontrib><creatorcontrib>Sugawara, Yasuhiko</creatorcontrib><creatorcontrib>Ikeda, Osamu</creatorcontrib><creatorcontrib>Inomata, Yukihiro</creatorcontrib><creatorcontrib>Hibi, Taizo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Liver transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sambommatsu, Yuzuru</au><au>Shimata, Keita</au><au>Ibuki, Sho</au><au>Narita, Yasuko</au><au>Isono, Kaori</au><au>Honda, Masaki</au><au>Irie, Tomoaki</au><au>Kadohisa, Masashi</au><au>Kawabata, Seiichi</au><au>Yamamoto, Hidekazu</au><au>Sugawara, Yasuhiko</au><au>Ikeda, Osamu</au><au>Inomata, Yukihiro</au><au>Hibi, Taizo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Portal Vein Complications After Adult Living Donor Liver Transplantation: Time of Onset and Deformity Patterns Affect Long‐Term Outcomes</atitle><jtitle>Liver transplantation</jtitle><addtitle>Liver Transpl</addtitle><date>2021-06</date><risdate>2021</risdate><volume>27</volume><issue>6</issue><spage>854</spage><epage>865</epage><pages>854-865</pages><issn>1527-6465</issn><eissn>1527-6473</eissn><abstract>Portal vein complications (PVCs) after adult living donor liver transplantation (LDLT) are potentially lethal. We categorized PVCs by the time of onset (early versus late, <1 month versus ≥1 month, respectively) and deformity patterns (portal vein stenosis [PVS], portal vein thrombosis [PVT], and portal vein occlusion [PVO]) to establish optimal treatment strategies. Overall, 35/322 (10.9%) recipients developed PVCs between 2000 and 2019. Pretransplant PVT (odds ratio [OR], 15.20; 95% confidence interval [CI], 3.70‐62.40; P < 0.001) was the only independent risk factor for PVS. In contrast, male sex (OR, 5.57; 95% CI, 1.71‐18.20; P = 0.004), pretransplant PVT (OR, 4.79; 95% CI, 1.64‐14.00; P = 0.004), and splenectomy (OR, 3.24; 95% CI, 1.23‐8.57; P = 0.018) were independent risk factors for PVT. PVS was successfully treated with interventional radiology regardless of its time of onset. On the other hand, late PVT and PVO had significantly lower treatment success rates (2/15, 13%) compared with those that occurred in the early period (10/11, 91%) despite aggressive intervention (P < 0.001). Deformity patterns had a significant impact on the 5‐year cumulative incidence of graft loss as a result of PVC (PVO + Yerdel grades 2‐4 PVT group [n = 16], 41% versus PVS + Yerdel grade 1 PVT group [n = 19], 0%; P = 0.02). In conclusion, late grades 2 to 4 PVT and PVO are refractory to treatment and associated with poor prognoses, whereas PVS has a good prognosis regardless of time of onset. A tailored approach according to the time of onset and deformity patterns of PVC is essential.</abstract><cop>United States</cop><pub>Wolters Kluwer Health, Inc</pub><pmid>33346927</pmid><doi>10.1002/lt.25977</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-5552-5539</orcidid><orcidid>https://orcid.org/0000-0001-7057-1544</orcidid><orcidid>https://orcid.org/0000-0002-6867-228X</orcidid><orcidid>https://orcid.org/0000-0003-4734-5084</orcidid><orcidid>https://orcid.org/0000-0002-6867-228</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1527-6465 |
| ispartof | Liver transplantation, 2021-06, Vol.27 (6), p.854-865 |
| issn | 1527-6465 1527-6473 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2471531534 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; Alma/SFX Local Collection |
| subjects | Adult Humans Liver transplantation Liver Transplantation - adverse effects Liver transplants Living Donors Male Occlusion Portal vein Portal Vein - diagnostic imaging Prognosis Retrospective Studies Risk factors Splenectomy Stenosis Thrombosis Venous Thrombosis - diagnostic imaging Venous Thrombosis - epidemiology |
| title | Portal Vein Complications After Adult Living Donor Liver Transplantation: Time of Onset and Deformity Patterns Affect Long‐Term Outcomes |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-03T11%3A15%3A36IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Portal%20Vein%20Complications%20After%20Adult%20Living%20Donor%20Liver%20Transplantation:%20Time%20of%20Onset%20and%20Deformity%20Patterns%20Affect%20Long%E2%80%90Term%20Outcomes&rft.jtitle=Liver%20transplantation&rft.au=Sambommatsu,%20Yuzuru&rft.date=2021-06&rft.volume=27&rft.issue=6&rft.spage=854&rft.epage=865&rft.pages=854-865&rft.issn=1527-6465&rft.eissn=1527-6473&rft_id=info:doi/10.1002/lt.25977&rft_dat=%3Cproquest_cross%3E2471531534%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2538111253&rft_id=info:pmid/33346927&rfr_iscdi=true |