VPB0438 - Thrombotic events of the spleno-portal axis in pre and post liver transplantation

Sunday, July 10, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: Virtual

Presenting Author(s)

Alicia Ortiz Lopez

HEMATOLOGY RESIDENT
HEMATOLOGY RESIDENT
Zaragoza, Aragon, Spain

Co-Author(s)

MH

María Hernández Aínsa

Hepatology service
Hospital Lozano Blesa
Zaragoza, Aragon, Spain
Irene Rivas Estabén, MD

Hematology resident
Hospital Lozano Blesa
Andorra (Teruel), Aragon, Spain
Sonia Angós Vázquez

Hematology resident
Hospital Lozano Blesa
zaragoza, Aragon, Spain
NG

Natalia María Gemperle Ortiz

Hematology resident
Hospital Lozano Blesa
zaragoza, Aragon, Spain
MM

Maria del Mar Moles Guerrero

Hematology resident
Hospital Lozano Blesa
zaragoza, Aragon, Spain
VM

Victoria Murillo Cortés

Hematology resident
Hospital Lozano Blesa
zaragoza, Aragon, Spain
sL

sara Lorente Pérez

Hepatology service
Hospital Lozano Blesa
zaragoza, Aragon, Spain
mD

manuela Dobón Rebollo

Hematology service
Hospital Lozano Blesa
zaragoza, Aragon, Spain
LP

Luis Palomera Bernal

Hematology service
Hospital Lozano Blesa
zaragoza, Aragon, Spain
OG

OLGA GAVIN Gavín Sebastian, PhD

Hematology service
Hospital Lozano Blesa
zaragoza, Aragon, Spain

Background: The alteration in the complex physiological balance between pro and anticoagulant factors existing in cirrhotic patients leads to an increased risk of deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE) and, notably, thrombosis of the splenoportal axis (PT).

Aims: To determine the incidence of PT in cirrhotic patients before and after liver transplantation and to analyze the management of anticoagulation in this area.

Methods: Descriptive and single-center observational study, in which a retrospective cohort of 78 patients undergoing liver transplant from March 2017 to August 2020 was reviewed.

Results: Of 78 patients, 80.8% (63/78) were men and 19.2% (15/78) women, with a median age of 60 years at the liver transplant. The main causes of liver transplant were alcohol (62%) and viral (16%).

Before transplant, there was 18% (14/78) of PT, being diagnosed with a median of 8 months before transplant. The 86% (12/14) received anticoagulation, 75% (9/12) with low molecular weight heparin (LMWH) and the rest with anti-vitamin K (AVK). Because of severe thrombocytopenia the 14% (2/14) couldn´t received anticoagulation.
We found two episodes of DVT before liver transplant, one of them also diagnosed with PT.

After transplant, we found 5.1% (4/78) of PT, detected with a median of 3 days after the transplant. The 50% (2/4) were treated with LMWH.
There was 7.7% (6/78) of DVT, diagnosed with a median of 7 months after transplant, 66.7% (4/6) of them treated with LMWH. The percentage in both types of events that did not receive anticoagulation was due to severe thrombocytopenia.

Conclusion(s): The incidence of PT found is similar to the one published in the reviewed literature. The high incidence of thrombosis after liver transplant forces us to implement improvements actions in the management of possible factors that favors the thrombotic event.