Anticoagulation to prevent PVT after liver transplantation for cirrhotic PVT

[Sarwa Darwish Murad]

Dear friends,

Please join our study, examining whether or not anticoagulation given after liver transplantation is effective for preventing PVT after liver transplantation. We encourage transplant centers who have a standard policy to administer anticoagulation for such patients, as well as centers who do not routinely give anticoagulation, as we are interested in the comparison. Hope to hear from you soon!
Iulia Minciuna (iuliabreaban@yahoo.com) and Sarwa Darwish Murad (s.darwishmurad@erasmusmc.nl)

Rationale
Non-tumoral portal vein thrombosis (PVT) affects 5–26% of liver transplant (LT) candidates. It is known that PVT complicates LT surgery and impacts post-LT outcomes, and hence anticoagulation (AC) is recommended by all guidelines. However, limited data exists on the effectiveness of post-LT AC to prevent PVT recurrence and a uniform policy among transplant centers is lacking.

Objectives
1) Determine whether post-LT AC in patients with preexisting PVT prevents post-LT PVT and/or improves outcomes
2) Identify which patients will benefit most from AC.

Study design
International multicenter retrospective observational study in centers within the network of the Vascular Liver Disease Interest Group (VALDIG) and the European Liver and Intestine Transplant Association (ELITA).

Material and Methods
Inclusion criteria: adult (≥18 years) LT recipients who underwent first liver transplantation between 2010 and 2024 for liver cirrhosis and who had PVT at time of LT.

Data collection: Clinical and imaging data will be extracted from institutional records and recorded in a specifically designed CASTOR database. The (limited) dataset includes recipient demographics, LT indication, extent and treatment of PVT pre-LT, basic donor data, surgical details, use of post-LT anticoagulation, postoperative PVT, bleeding complications, graft and patient survival.

Primary outcome: post-LT PVT
Secondary outcome: anticoagulation safety (major bleeding), graft and patient survival

[Carl Jorns]

Hi Sarwa,
this is a very interesting and important study to do. Congratulations. Karolinska University Hospital would love to contribute in case you are in need of more participating centers. Do not hesitate to reach out: carl.jorns@ki.se
Best
carl

[Author]

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