PREVALENCIA DE TROMBOSIS PORTAL EN PACIENTES CIRRÓTICOS EN EVALUACIÓN PRETRASPLANTE. HOSPITAL LUIS VERNAZA, 2015-2016

Abstract

Portal thrombosis refers to a complete or partial obstruction of portal flow due to the presence of a luminal thrombus. It has a prevalence of 1% in the general population and between 5-25% in cirrhotic patients. It has been associated with the severity of liver disease and postoperative complications; however no causality has been established between the latter. Some of the factors that have been associated with this finding are: elevated MELD score, elevated CHILD score, decreased portal flow rate, and the presence of hereditary prothrombotic factors. The analyzed sample was the patients in pre-transplant evaluation during the period 2015-2016 of the Transplant Center, Hospital Luis Vernaza. Of the 57 patients, 5 reported portal thrombosis, obtaining a general prevalence of 8.8%. The location of the occlusion in the studied population had the following distribution: 40% partial thrombosis, 40% total thrombosis, 20% chronic thrombosis. The etiology of cirrhosis was reported: NASH (25; 44%) followed by autoimmune (15; 26%), cryptogenic (7; 12%), viral (4;7%), alcoholic (4;7%), and secondary biliary cirrhosis in 2 patients (2; 4%), being the most common NASH and with a similar distribution in the rest. The mean values obtained in relation to the presence or absence of thrombosis were MELD 18 ± 10; 13 ± 5, Platelets 96 ± 46.7; 88.7 ± 79.3 respectively, which did not demonstrate statistical significance. It was demonstrated that portal venous thrombosis is a clinical problem in our environment, specifically in the population studied. Although relatively low, it adheres to the international literature. To date there are no epidemiological data on portal venous thrombosis in Ecuador. Their identification has great clinical relevance, since it is related to the general xii deterioration of the patient, short-term complications in the post-transplant period and could constitute a contraindication to transplantation.