The Risk Factors for Portal Vein Thrombosis After Living Donor Liver Transplantation in Adults

Objectives In living donor liver transplantation (LDLT), recipients’ portal vein (PV) is short and thin. Then, PV thrombosis was sometimes occurred in LDLT. The PV thrombosis can be lethal complications, especially in adult cases. The purpose of this study was to examine the risk factors of PV thrombosis after LDLT, especially in adults’ cases. [Methods] From July 1991 to July 2017, we performed 170 cases of LDLT. In those cases, there were 83cases of adults’ LDLT. We performed univariate and multivariate analyses not only in all LDLT cases but also in adults’ LDLT cases to identify the independent risk factors for PV thrombosis. Results In all LDLT cases, the risk factors identified to be associated with a P<0.05 were lumen diameter of PV (0.0183), blood loss (0.0131), and pre-operative PV thrombosis (0.0034) on the univariate analysis. On the multiple logistic regression analysis of all LDLT cases, we identified lumen diameter of PV and pre-operative PV thrombosis to be the independent risk factors for PV thrombosis. However, in the adults’ LDLT cases, the lumen diameter of PV was not so related with the complications. Then, we performed the same analysis only in adults’ LDLT cases. In adults’ cases, the risk factors of PV thrombosis were LDLT without splenectomy (P=0.0363), blood loss (0.0145), and pre-operative PV thrombosis (0.0012) on the univariate analysis. On the multiple logistic regression analysis of adults’ cases, we identified LDLT without splenectomy and pre-operative PV thrombosis to be the independent the risk factors for PV thrombosis. [Conclusion] In adults’ LDLT cases, the independent risk factors for PV thrombosis were LDLT without splenectomy and pre-operative PV thrombosis.