Healthcare Costs and Early Complications in Liver-Transplanted Patients With Portal Vein Thrombosis: Experience From a Colombian Reference Center.

Abstract

Objectives: This study aimed to analyze the direct healthcare costs and early complications associated with pretransplant portal vein thrombosis (PVT) in cirrhotic patients undergoing their first orthotopic liver transplant (LT) at a hospital in Colombia from 2013 to 2021.

Methods: A registry-based retrospective follow-up study was conducted on cirrhotic patients aged 14 years or older who underwent their first LT at the San Vicente Fundación Rionegro Hospital between January 2013 and April 2021. The primary outcomes were early (30-day) vascular and biliary complications and direct healthcare costs. The generalized linear model was used to estimate observed and adjusted mean differences in costs and risk ratios for complications based on pretransplant PVT. Costs were expressed in 2020 international dollars.

Results: The medical records of 161 patients were analyzed, with 15.5% having pretransplant PVT. Patients with pretransplant PVT exhibited a statistically significant higher risk of early vascular complications (adjusted risk ratio 2.17; 95% CI 1.04-4.51; P = .039). However, there was no statistically significant difference in the risk of early biliary complications (P = .225). Patients with grade I PVT did not show a significant difference in costs compared with patients without PVT (P = .661). For patients with grade II-IV PVT, the adjusted mean difference in the healthcare cost was 33 175 international dollars (95% CI 730-65 620).

Conclusions: Patients with pretransplant grade II-IV PVT have a higher risk of early vascular complications and require more medical resources, leading to increased costs associated with LT.