Advanced non-alcoholic steatohepatitis cirrhosis: A high-risk population for pre-liver transplant portal vein thrombosis

Jonathan G. Stine, Curtis K. Argo, Shawn J. Pelletier, Daniel G. Maluf, Stephen H. Caldwell, Patrick G. Northup

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

AIM To examine if liver transplant recipients with high-risk non-alcoholic steatohepatitis (NASH) are at increased risk for pre-transplant portal venous thrombosis. METHODS Data on all liver transplants in the United States from February 2002 through September 2014 were analyzed. Recipients were sorted into three distinct groups: High-risk (age > 60, body mass index > 30 kg/m2, hypertension and diabetes), low-risk and non-NASH cirrhosis. Multivariable logistic regression models were constructed. RESULTS Thirty-five thousand and seventy-two candidates underwent liver transplantation and of those organ recipients, 465 were transplanted for high-risk and 2775 for lowrisk NASH. Two thousand six hundred and twentysix (7.5%) recipients had pre-transplant portal vein thrombosis; 66 (14.2%) of the high-risk NASH group had portal vein thrombosis vs 328 (11.8%) of the lowrisk NASH group. In general, all NASH recipients were less likely to be male or African American and more likely to be obese. In adjusted multivariable regression analyses, high-risk recipients had the greatest risk of pre-transplant portal vein thrombosis with OR = 2.11 (95%CI: 1.60-2.76, p < 0.001) when referenced to the non-NASH group. CONCLUSION Liver transplant candidates with high-risk NASH are at the greatest risk for portal vein thrombosis development prior to transplantation. These candidates may benefit from interventions to decrease their likelihood of clot formation and resultant downstream hepatic decompensating events. Prospective study is needed.

Original languageEnglish (US)
Pages (from-to)139-146
Number of pages8
JournalWorld Journal of Hepatology
Volume9
Issue number3
DOIs
StatePublished - Jan 1 2017

Fingerprint

Fatty Liver
Portal Vein
Thrombosis
Fibrosis
Transplants
Liver
Population
Logistic Models
Venous Thrombosis
African Americans
Liver Transplantation
Body Mass Index
Transplantation
Regression Analysis
Prospective Studies
Hypertension

All Science Journal Classification (ASJC) codes

  • Hepatology

Cite this

Stine, Jonathan G. ; Argo, Curtis K. ; Pelletier, Shawn J. ; Maluf, Daniel G. ; Caldwell, Stephen H. ; Northup, Patrick G. / Advanced non-alcoholic steatohepatitis cirrhosis : A high-risk population for pre-liver transplant portal vein thrombosis. In: World Journal of Hepatology. 2017 ; Vol. 9, No. 3. pp. 139-146.
@article{3760c2892a28425185bbac1be3ea5ff2,
title = "Advanced non-alcoholic steatohepatitis cirrhosis: A high-risk population for pre-liver transplant portal vein thrombosis",
abstract = "AIM To examine if liver transplant recipients with high-risk non-alcoholic steatohepatitis (NASH) are at increased risk for pre-transplant portal venous thrombosis. METHODS Data on all liver transplants in the United States from February 2002 through September 2014 were analyzed. Recipients were sorted into three distinct groups: High-risk (age > 60, body mass index > 30 kg/m2, hypertension and diabetes), low-risk and non-NASH cirrhosis. Multivariable logistic regression models were constructed. RESULTS Thirty-five thousand and seventy-two candidates underwent liver transplantation and of those organ recipients, 465 were transplanted for high-risk and 2775 for lowrisk NASH. Two thousand six hundred and twentysix (7.5{\%}) recipients had pre-transplant portal vein thrombosis; 66 (14.2{\%}) of the high-risk NASH group had portal vein thrombosis vs 328 (11.8{\%}) of the lowrisk NASH group. In general, all NASH recipients were less likely to be male or African American and more likely to be obese. In adjusted multivariable regression analyses, high-risk recipients had the greatest risk of pre-transplant portal vein thrombosis with OR = 2.11 (95{\%}CI: 1.60-2.76, p < 0.001) when referenced to the non-NASH group. CONCLUSION Liver transplant candidates with high-risk NASH are at the greatest risk for portal vein thrombosis development prior to transplantation. These candidates may benefit from interventions to decrease their likelihood of clot formation and resultant downstream hepatic decompensating events. Prospective study is needed.",
author = "Stine, {Jonathan G.} and Argo, {Curtis K.} and Pelletier, {Shawn J.} and Maluf, {Daniel G.} and Caldwell, {Stephen H.} and Northup, {Patrick G.}",
year = "2017",
month = "1",
day = "1",
doi = "10.4254/wjh.v9.i3.139",
language = "English (US)",
volume = "9",
pages = "139--146",
journal = "World Journal of Hepatology",
issn = "1948-5182",
publisher = "Baishideng Publishing Group",
number = "3",

}

Advanced non-alcoholic steatohepatitis cirrhosis : A high-risk population for pre-liver transplant portal vein thrombosis. / Stine, Jonathan G.; Argo, Curtis K.; Pelletier, Shawn J.; Maluf, Daniel G.; Caldwell, Stephen H.; Northup, Patrick G.

In: World Journal of Hepatology, Vol. 9, No. 3, 01.01.2017, p. 139-146.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Advanced non-alcoholic steatohepatitis cirrhosis

T2 - A high-risk population for pre-liver transplant portal vein thrombosis

AU - Stine, Jonathan G.

AU - Argo, Curtis K.

AU - Pelletier, Shawn J.

AU - Maluf, Daniel G.

AU - Caldwell, Stephen H.

AU - Northup, Patrick G.

PY - 2017/1/1

Y1 - 2017/1/1

N2 - AIM To examine if liver transplant recipients with high-risk non-alcoholic steatohepatitis (NASH) are at increased risk for pre-transplant portal venous thrombosis. METHODS Data on all liver transplants in the United States from February 2002 through September 2014 were analyzed. Recipients were sorted into three distinct groups: High-risk (age > 60, body mass index > 30 kg/m2, hypertension and diabetes), low-risk and non-NASH cirrhosis. Multivariable logistic regression models were constructed. RESULTS Thirty-five thousand and seventy-two candidates underwent liver transplantation and of those organ recipients, 465 were transplanted for high-risk and 2775 for lowrisk NASH. Two thousand six hundred and twentysix (7.5%) recipients had pre-transplant portal vein thrombosis; 66 (14.2%) of the high-risk NASH group had portal vein thrombosis vs 328 (11.8%) of the lowrisk NASH group. In general, all NASH recipients were less likely to be male or African American and more likely to be obese. In adjusted multivariable regression analyses, high-risk recipients had the greatest risk of pre-transplant portal vein thrombosis with OR = 2.11 (95%CI: 1.60-2.76, p < 0.001) when referenced to the non-NASH group. CONCLUSION Liver transplant candidates with high-risk NASH are at the greatest risk for portal vein thrombosis development prior to transplantation. These candidates may benefit from interventions to decrease their likelihood of clot formation and resultant downstream hepatic decompensating events. Prospective study is needed.

AB - AIM To examine if liver transplant recipients with high-risk non-alcoholic steatohepatitis (NASH) are at increased risk for pre-transplant portal venous thrombosis. METHODS Data on all liver transplants in the United States from February 2002 through September 2014 were analyzed. Recipients were sorted into three distinct groups: High-risk (age > 60, body mass index > 30 kg/m2, hypertension and diabetes), low-risk and non-NASH cirrhosis. Multivariable logistic regression models were constructed. RESULTS Thirty-five thousand and seventy-two candidates underwent liver transplantation and of those organ recipients, 465 were transplanted for high-risk and 2775 for lowrisk NASH. Two thousand six hundred and twentysix (7.5%) recipients had pre-transplant portal vein thrombosis; 66 (14.2%) of the high-risk NASH group had portal vein thrombosis vs 328 (11.8%) of the lowrisk NASH group. In general, all NASH recipients were less likely to be male or African American and more likely to be obese. In adjusted multivariable regression analyses, high-risk recipients had the greatest risk of pre-transplant portal vein thrombosis with OR = 2.11 (95%CI: 1.60-2.76, p < 0.001) when referenced to the non-NASH group. CONCLUSION Liver transplant candidates with high-risk NASH are at the greatest risk for portal vein thrombosis development prior to transplantation. These candidates may benefit from interventions to decrease their likelihood of clot formation and resultant downstream hepatic decompensating events. Prospective study is needed.

UR - http://www.scopus.com/inward/record.url?scp=85010966265&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85010966265&partnerID=8YFLogxK

U2 - 10.4254/wjh.v9.i3.139

DO - 10.4254/wjh.v9.i3.139

M3 - Article

C2 - 28217250

AN - SCOPUS:85010966265

VL - 9

SP - 139

EP - 146

JO - World Journal of Hepatology

JF - World Journal of Hepatology

SN - 1948-5182

IS - 3

ER -