African Americans have a lower prevalence of portal vein thrombosis at the time of liver transplantation

HPB : the Official Journal of the International Hepato Pancreato Biliary Association
Dmitri BezinoverPiotr K Janicki

Abstract

Perioperative vascular thrombotic events in patients undergoing liver transplantation (LT) are associated with significant morbidity and mortality. In this retrospective UNOS database analysis, we evaluated the prevalence of portal vein thrombosis (PVT) and factors contributing to PVT development in different ethnic groups. Of the 47 953 LT performed between 2002 and 2015, we identified 3642 cases of PVT. African Americans (AA) had a significantly lower prevalence of PVT compared to other ethnic groups (p = 0.0001). Multivariable regression analysis confirmed that AA were less likely than other ethnicities to have PVT (OR = 0.6). AA cohort was more likely to have infectious or autoimmune causes of liver failure (OR = 1.6, 1.7 respectively) as well as higher creatinine and INR compared to other groups (OR = 1.6, 1.3 respectively). AA's were less likely to have encephalopathy, ascites, or variceal bleeding, which might indicate lower portal pressures. AA's were listed for LT later than other ethnicities and had both a lower functional status and higher MELD score at the time of registration. AA's had a significantly lower prevalence of preoperative PVT despite having a greater number of factors predisposing to thrombosis. This pr...Continue Reading

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Citations

Aug 23, 2019·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Daniel GaballaJonathan G Stine
Oct 15, 2019·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Jacqueline G O'Leary
Feb 14, 2020·Liver International : Official Journal of the International Association for the Study of the Liver·Bernhard ScheinerMattias Mandorfer
Aug 24, 2017·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Kendra D Conzen, Elizabeth A Pomfret
Dec 12, 2018·Transplantation Direct·Thomas A VerbeekDmitri Bezinover

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