Portal vein thrombosis: diagnosis, management, and endpoints for future clinical studies

ERN RARE-LIVER and VALDIG, an EASL consortium; Laure Elkrief; Virginia Hernandez-Gea; Marco Senzolo; Agustin Albillos; Anna Baiges; Annalisa Berzigotti; Christophe Bureau; Sarwa Darwish Murad; Andrea De Gottardi; François Durand; Juan Carlos Garcia-Pagan; Ton Lisman; Mattias Mandorfer; Valérie McLin; Lucile Moga; Filipe Nery; Patrick Northup; Alexandre Nuzzo; Valérie Paradis; David Patch; Audrey Payancé; Vincent Plaforet; Aurélie Plessier; Johanne Poisson; Lara Roberts; Riad Salem; Shiv Sarin; Akash Shukla; Christian Toso; Dhiraj Tripathi; Dominique Valla; Maxime Ronot; Pierre Emmanuel Rautou

doi:10.1016/S2468-1253(24)00155-9

Portal vein thrombosis: diagnosis, management, and endpoints for future clinical studies

ERN RARE-LIVER and VALDIG, an EASL consortium, Laure Elkrief, Virginia Hernandez-Gea, Marco Senzolo, Agustin Albillos, Anna Baiges, Annalisa Berzigotti, Christophe Bureau, Sarwa Darwish Murad, Andrea De Gottardi, François Durand, Juan Carlos Garcia-Pagan, Ton Lisman, Mattias Mandorfer, Valérie McLin, Lucile Moga, Filipe Nery, Patrick Northup, Alexandre Nuzzo, Valérie ParadisDavid Patch, Audrey Payancé, Vincent Plaforet, Aurélie Plessier, Johanne Poisson, Lara Roberts, Riad Salem, Shiv Sarin, Akash Shukla, Christian Toso, Dhiraj Tripathi, Dominique Valla, Maxime Ronot, Pierre Emmanuel Rautou^*

^*Corresponding author for this work

Groningen Institute for Organ Transplantation (GIOT)

Research output: Contribution to journal › Review article › peer-review

8 Citations (Scopus)

Abstract

Portal vein thrombosis (PVT) refers to the development of a non-malignant obstruction of the portal vein, its branches, its radicles, or a combination. This Review first provides a comprehensive overview of all aspects of PVT, namely the specifics of the portal venous system, the risk factors for PVT, the pathophysiology of portal hypertension in PVT, the interest in non-invasive tests, as well as therapeutic approaches including the effect of treating risk factors for PVT or cause of cirrhosis, anticoagulation, portal vein recanalisation by interventional radiology, and prevention and management of variceal bleeding in patients with PVT. Specific issues are also addressed including portal cholangiopathy, mesenteric ischaemia and intestinal necrosis, quality of life, fertility, contraception and pregnancy, and PVT in children. This Review will then present endpoints for future clinical studies in PVT, both in patients with and without cirrhosis, agreed by a large panel of experts through a Delphi consensus process. These endpoints include classification of portal vein thrombus extension, classification of PVT evolution, timing of assessment of PVT, and global endpoints for studies on PVT including clinical outcomes. These endpoints will help homogenise studies on PVT and thus facilitate reporting, comparison between studies, and validation of future studies and trials on PVT.

Original language	English
Pages (from-to)	859-883
Number of pages	25
Journal	The Lancet Gastroenterology and Hepatology
Volume	9
Issue number	9
DOIs	https://doi.org/10.1016/S2468-1253(24)00155-9
Publication status	Published - Sept-2024

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ERN RARE-LIVER and VALDIG, an EASL consortium, Elkrief, L., Hernandez-Gea, V., Senzolo, M., Albillos, A., Baiges, A., Berzigotti, A., Bureau, C., Murad, S. D., De Gottardi, A., Durand, F., Garcia-Pagan, J. C., Lisman, T., Mandorfer, M., McLin, V., Moga, L., Nery, F., Northup, P., Nuzzo, A., ... Rautou, P. E. (2024). Portal vein thrombosis: diagnosis, management, and endpoints for future clinical studies. The Lancet Gastroenterology and Hepatology, 9(9), 859-883. https://doi.org/10.1016/S2468-1253(24)00155-9

@article{da243e46775746e388f295c2fb636fde,

title = "Portal vein thrombosis: diagnosis, management, and endpoints for future clinical studies",

abstract = "Portal vein thrombosis (PVT) refers to the development of a non-malignant obstruction of the portal vein, its branches, its radicles, or a combination. This Review first provides a comprehensive overview of all aspects of PVT, namely the specifics of the portal venous system, the risk factors for PVT, the pathophysiology of portal hypertension in PVT, the interest in non-invasive tests, as well as therapeutic approaches including the effect of treating risk factors for PVT or cause of cirrhosis, anticoagulation, portal vein recanalisation by interventional radiology, and prevention and management of variceal bleeding in patients with PVT. Specific issues are also addressed including portal cholangiopathy, mesenteric ischaemia and intestinal necrosis, quality of life, fertility, contraception and pregnancy, and PVT in children. This Review will then present endpoints for future clinical studies in PVT, both in patients with and without cirrhosis, agreed by a large panel of experts through a Delphi consensus process. These endpoints include classification of portal vein thrombus extension, classification of PVT evolution, timing of assessment of PVT, and global endpoints for studies on PVT including clinical outcomes. These endpoints will help homogenise studies on PVT and thus facilitate reporting, comparison between studies, and validation of future studies and trials on PVT.",

author = "{ERN RARE-LIVER and VALDIG, an EASL consortium} and Laure Elkrief and Virginia Hernandez-Gea and Marco Senzolo and Agustin Albillos and Anna Baiges and Annalisa Berzigotti and Christophe Bureau and Murad, {Sarwa Darwish} and {De Gottardi}, Andrea and Fran{\c c}ois Durand and Garcia-Pagan, {Juan Carlos} and Ton Lisman and Mattias Mandorfer and Val{\'e}rie McLin and Lucile Moga and Filipe Nery and Patrick Northup and Alexandre Nuzzo and Val{\'e}rie Paradis and David Patch and Audrey Payanc{\'e} and Vincent Plaforet and Aur{\'e}lie Plessier and Johanne Poisson and Lara Roberts and Riad Salem and Shiv Sarin and Akash Shukla and Christian Toso and Dhiraj Tripathi and Dominique Valla and Maxime Ronot and Rautou, {Pierre Emmanuel}",

note = "Publisher Copyright: {\textcopyright} 2024 Elsevier Ltd",

year = "2024",

month = sep,

doi = "10.1016/S2468-1253(24)00155-9",

language = "English",

volume = "9",

pages = "859--883",

journal = "The Lancet Gastroenterology and Hepatology",

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ERN RARE-LIVER and VALDIG, an EASL consortium, Elkrief, L, Hernandez-Gea, V, Senzolo, M, Albillos, A, Baiges, A, Berzigotti, A, Bureau, C, Murad, SD, De Gottardi, A, Durand, F, Garcia-Pagan, JC, Lisman, T, Mandorfer, M, McLin, V, Moga, L, Nery, F, Northup, P, Nuzzo, A, Paradis, V, Patch, D, Payancé, A, Plaforet, V, Plessier, A, Poisson, J, Roberts, L, Salem, R, Sarin, S, Shukla, A, Toso, C, Tripathi, D, Valla, D, Ronot, M & Rautou, PE 2024, 'Portal vein thrombosis: diagnosis, management, and endpoints for future clinical studies', The Lancet Gastroenterology and Hepatology, vol. 9, no. 9, pp. 859-883. https://doi.org/10.1016/S2468-1253(24)00155-9

TY - JOUR

T1 - Portal vein thrombosis

T2 - diagnosis, management, and endpoints for future clinical studies

AU - ERN RARE-LIVER and VALDIG, an EASL consortium

AU - Elkrief, Laure

AU - Hernandez-Gea, Virginia

AU - Senzolo, Marco

AU - Albillos, Agustin

AU - Baiges, Anna

AU - Berzigotti, Annalisa

AU - Bureau, Christophe

AU - Murad, Sarwa Darwish

AU - De Gottardi, Andrea

AU - Durand, François

AU - Garcia-Pagan, Juan Carlos

AU - Lisman, Ton

AU - Mandorfer, Mattias

AU - McLin, Valérie

AU - Moga, Lucile

AU - Nery, Filipe

AU - Northup, Patrick

AU - Nuzzo, Alexandre

AU - Paradis, Valérie

AU - Patch, David

AU - Payancé, Audrey

AU - Plaforet, Vincent

AU - Plessier, Aurélie

AU - Poisson, Johanne

AU - Roberts, Lara

AU - Salem, Riad

AU - Sarin, Shiv

AU - Shukla, Akash

AU - Toso, Christian

AU - Tripathi, Dhiraj

AU - Valla, Dominique

AU - Ronot, Maxime

AU - Rautou, Pierre Emmanuel

PY - 2024/9

Y1 - 2024/9

N2 - Portal vein thrombosis (PVT) refers to the development of a non-malignant obstruction of the portal vein, its branches, its radicles, or a combination. This Review first provides a comprehensive overview of all aspects of PVT, namely the specifics of the portal venous system, the risk factors for PVT, the pathophysiology of portal hypertension in PVT, the interest in non-invasive tests, as well as therapeutic approaches including the effect of treating risk factors for PVT or cause of cirrhosis, anticoagulation, portal vein recanalisation by interventional radiology, and prevention and management of variceal bleeding in patients with PVT. Specific issues are also addressed including portal cholangiopathy, mesenteric ischaemia and intestinal necrosis, quality of life, fertility, contraception and pregnancy, and PVT in children. This Review will then present endpoints for future clinical studies in PVT, both in patients with and without cirrhosis, agreed by a large panel of experts through a Delphi consensus process. These endpoints include classification of portal vein thrombus extension, classification of PVT evolution, timing of assessment of PVT, and global endpoints for studies on PVT including clinical outcomes. These endpoints will help homogenise studies on PVT and thus facilitate reporting, comparison between studies, and validation of future studies and trials on PVT.

AB - Portal vein thrombosis (PVT) refers to the development of a non-malignant obstruction of the portal vein, its branches, its radicles, or a combination. This Review first provides a comprehensive overview of all aspects of PVT, namely the specifics of the portal venous system, the risk factors for PVT, the pathophysiology of portal hypertension in PVT, the interest in non-invasive tests, as well as therapeutic approaches including the effect of treating risk factors for PVT or cause of cirrhosis, anticoagulation, portal vein recanalisation by interventional radiology, and prevention and management of variceal bleeding in patients with PVT. Specific issues are also addressed including portal cholangiopathy, mesenteric ischaemia and intestinal necrosis, quality of life, fertility, contraception and pregnancy, and PVT in children. This Review will then present endpoints for future clinical studies in PVT, both in patients with and without cirrhosis, agreed by a large panel of experts through a Delphi consensus process. These endpoints include classification of portal vein thrombus extension, classification of PVT evolution, timing of assessment of PVT, and global endpoints for studies on PVT including clinical outcomes. These endpoints will help homogenise studies on PVT and thus facilitate reporting, comparison between studies, and validation of future studies and trials on PVT.

UR - http://www.scopus.com/inward/record.url?scp=85198581219&partnerID=8YFLogxK

U2 - 10.1016/S2468-1253(24)00155-9

DO - 10.1016/S2468-1253(24)00155-9

M3 - Review article

C2 - 38996577

AN - SCOPUS:85198581219

SN - 2468-1253

VL - 9

SP - 859

EP - 883

JO - The Lancet Gastroenterology and Hepatology

JF - The Lancet Gastroenterology and Hepatology

IS - 9

ER -

Portal vein thrombosis: diagnosis, management, and endpoints for future clinical studies

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