Influence of Immunocomplexes in Vascular Thrombosis in Liver Transplantation

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Abstract

Introduction

Vascular thrombosis is one of the most severe complications related to organ transplantation. While immunocomplex presence has been associated with this complication in both kidney and heart transplantation, its etiology in the setting of liver transplantation remains unknown.

Objectives

To evaluate whether immunocomplexes have an impact in the development of graft vascular thrombosis in liver transplant recipients.

Methods

We performed a retrospective comparative study, including patients who underwent liver transplantation (n=373) during the study period between March 2000 and June 2013, at the University Hospital "12 de Octubre” (Madrid-Spain). Two groups were defined according to immunocomplex analysis: group 1 with a positive result and group 2 with negative immunocomplex study.

Results

Mean age was 54±10,5 years in group 1 vs 54 ± 10,5 years in group 2 (p=NS). 75% and 68.5% of patients were male in groups 1 and 2 respectively. There were no statistically significant differences when comparing BMI or average MELD score, which was 15.49 in group 1 and 15.94 in group 2 (p=NS). The rate of hepatocellular carcinoma was 16.1% in group 1 vs 27.6% in group 2 (p 0.007), while HCV infection was 38.5% in group 1 and 54.7% in group 2 (p 0.002). No statistically significant differences were found related to blood product transfusion, ICU or ward stay.

Results

Pretransplant portal thrombosis was 13.2% in group 1 vs 16% in group 2 (p 0.05). However, there were no statistically significant differences regarding post-transplant arterial thrombosis (4.2% group 1 vs 3.4% group 2; p 0.63) or in relation to post-transplant portal thrombosis, which was 1% in group 1 and 1.1% in group 2 (p 0.95).

Results

Actuarial survival rates at 1, 3 and 5 years for group 1 were 85.6%, 76.6%, and 71.3% respectively, while for group 2 they were 80.7%, 72.9% and 66.3%, without significant differences identified (p 0.109).

Conclusion

In our series, immunocomplex presence has not been confirmed to be a relevant factor in the development of graft vascular thrombosis in liver transplantation.

Conclusion

Hospital 12 de Octubre.

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