1. Thrombosis after liver transplantation for hepatocellular carcinoma
- Author
-
E. Longhi, Sherrie Bhoori, Maria Abbattista, Alberto Maino, Andrea Artoni, Marta Serafini, Ida Martinelli, Tullia Maria De Feo, Giorgio Rossi, Paolo Bucciarelli, Vincenzo Mazzaferro, Umberto Maggi, and Francesca R. Ponziani
- Subjects
RNA viruses ,Male ,medicine.medical_treatment ,lcsh:Medicine ,Hepacivirus ,Cardiovascular Medicine ,Liver transplantation ,Vascular Medicine ,Biochemistry ,Gastroenterology ,Postoperative Complications ,0302 clinical medicine ,Medicine and Health Sciences ,Thrombophilia ,Medicine ,lcsh:Science ,Pathology and laboratory medicine ,Multidisciplinary ,Hepatitis C virus ,Liver Diseases ,Mortality rate ,Liver Neoplasms ,Hematology ,Proteases ,Medical microbiology ,Middle Aged ,Thrombosis ,Enzymes ,Survival Rate ,Venous thrombosis ,Oncology ,Cardiovascular Diseases ,030220 oncology & carcinogenesis ,Viruses ,Prothrombin G20210A ,Female ,030211 gastroenterology & hepatology ,Pathogens ,Research Article ,Hepatitis B virus ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Death Rates ,Surgical and Invasive Medical Procedures ,Gastroenterology and Hepatology ,Carcinomas ,Microbiology ,Disease-Free Survival ,Digestive System Procedures ,03 medical and health sciences ,Population Metrics ,Internal medicine ,Gastrointestinal Tumors ,Factor V Leiden ,Humans ,Blood Coagulation ,Survival rate ,Aged ,Transplantation ,Coagulation Disorders ,Population Biology ,Flaviviruses ,business.industry ,lcsh:R ,Organisms ,Viral pathogens ,Biology and Life Sciences ,Proteins ,Cancers and Neoplasms ,Organ Transplantation ,Hepatocellular Carcinoma ,medicine.disease ,Hepatitis viruses ,Liver Transplantation ,Microbial pathogens ,Enzymology ,lcsh:Q ,Serine Proteases ,business ,Follow-Up Studies - Abstract
The influence of thrombosis on the prognosis of patients with hepatocellular carcinoma (HCC) after liver transplantation (LT) and the role of the commonest inherited thrombophilia abnormalities factor V Leiden and prothrombin G20210A in the development of thrombosis are unknown. We investigated a cohort of patients who underwent LT for HCC with the aim to estimate the incidence rate (IR) of thrombosis, its influence on mortality and re-transplantation rates and, in the frame of a nested case-control study, the role of thrombophilia in donors and recipients for the development of thrombosis. Four-hundred and thirty patients underwent LT and were followed for a median of 7.2 years. Twenty-six recipients (6%) developed thrombosis (IR 1.06 [95%CI: 0.71-1.53] per 100 pts-yr). Mortality rate after LT was 3.95 (95%CI: 3.22-4.79) per 100 pts-yr and was not influenced by thrombosis. Re-transplantation was planned for 33 patients and was more common in patients with thrombosis than in those without (HR 2.50 [95%CI: 0.87-7.17]). The risk of thrombosis was 4 times higher in recipients with thrombophilia than in those without (OR 4.23 [95%CI: 0.99-18.04]) and 6 times higher when the analysis was restricted to venous thrombosis (OR 6.26 [95%CI: 1.19-32.85]). The presence of inherited thrombophilia in the donors did not increase the risk of thrombosis of the recipient. In conclusion, thrombosis is a complication of 6% of patients transplanted for HCC and increases the risk of re-transplantation but not of mortality. The risk of thrombosis, particularly venous, is increased in the presence of thrombophilia abnormalities in the recipients.
- Published
- 2017