Predicting portal thrombosis in cirrhosis: A prospective study of clinical, ultrasonographic and hemostatic factors

Fanny Turon, Ellen G. Driever, Anna Baiges, Eira Cerda, Angeles Garcia-Criado, Rosa Gilabert, Concepcio Bru, Annalisa Berzigotti, Isabel Nunez, Lara Orts, Juan Carlos Reverter, Marta Magaz, Genis Camprecios, Pol Olivas, Fabian Betancourt-Sanchez, Valeria Perez-Campuzano, Annabel Blasi, Susana Seijo, Enric Reverter, Jaume BoschRoger Borras, Virginia Hernandez-Gea, Ton Lisman, Juan Carlos Garcia-Pagan*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

67 Citations (Scopus)
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Abstract

Background & Aims: Portal vein thrombosis (PVT) is a relatively frequent event in patients with cirrhosis. While different risk factors for PVT have been reported, such as decreased portal blood flow velocity (PBFV) and parameters related with severity of portal hypertension, these are based on retrospective studies assessing only a discrete number of parameters. The aim of the current study was to evaluate the incidence and risks factors for non-tumoral PVT development in a large prospective cohort of patients with cirrhosis.

Methods: We performed an exhaustive evaluation of clinical, biochemical, inflammatory and acquired/hereditary hemostatic profiles in 369 patients with cirrhosis without PVT who were prospectively followed-up. Doppler ultrasound was performed at baseline and every 6 months or whenever clinically indicated. PVT development was always confirmed by computed tomography.

Results: Twenty-nine patients developed non-tumoral PVT, with an incidence of 1.6%, 6% and 8.4% at 1, 3 and 5 years, respectively. Low platelet count, PBFV

Conclusions: In patients with cirrhosis, the factors predictive of PVT development were mainly those related to the severity of portal hypertension. Our results do not support the role of hemostatic alterations (inherited or acquired) and inflammatory markers in the prediction of PVT in patients with cirrhosis.

Lay summary: Patients with cirrhosis and more severe portal hypertension are at higher risk of non-tumoral portal vein thrombosis development. Acquired or inherited hemostatic disorders, as well as inflammatory status, do not seem to predict the development of portal vein thrombosis in patients with cirrhosis.(C) 2021 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Original languageEnglish
Pages (from-to)1367-1376
Number of pages11
JournalJournal of Hepatology
Volume75
Issue number6
DOIs
Publication statusPublished - Dec-2021

Keywords

  • Cirrhosis
  • portal vein thrombosis
  • portal hypertension
  • FIBRIN CLOT STRUCTURE
  • VEIN-THROMBOSIS
  • ENDOTHELIAL DYSFUNCTION
  • LIVER-TRANSPLANTATION
  • FACTOR-XIII
  • RISK
  • PATHOPHYSIOLOGY
  • HYPERTENSION
  • COAGULATION
  • DEFICIENCY

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