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Turon F, Driever EG, Baiges A, et al. Predicting portal thrombosis in cirrhosis: A prospective study of clinical, ultrasonographic and hemostatic factors. J Hepatol. 2021;75(6):1367-1376doi: 10.1016/j.jhep.2021.07.020.
Turon, F., Driever, E. G., Baiges, A., Cerda, E., García-Criado, �. �., Gilabert, R., Bru, C., Berzigotti, A., Nuñez, I., Orts, L., Reverter, J. C., Magaz, M., Camprecios, G., Olivas, P., Betancourt-Sanchez, F., Perez-Campuzano, V., Blasi, A., Seijo, S., Reverter, E., Bosch, J., Borràs, R., Hernandez-Gea, V., Lisman, T., & Garcia-Pagan, J. C. (2021). Predicting portal thrombosis in cirrhosis: A prospective study of clinical, ultrasonographic and hemostatic factors. Journal of hepatology, 75(6), 1367-1376. https://doi.org/10.1016/j.jhep.2021.07.020
Turon, Fanny, et al. "Predicting portal thrombosis in cirrhosis: A prospective study of clinical, ultrasonographic and hemostatic factors." Journal of hepatology vol. 75,6 (2021): 1367-1376. doi: https://doi.org/10.1016/j.jhep.2021.07.020
Turon F, Driever EG, Baiges A, Cerda E, García-Criado Á, Gilabert R, Bru C, Berzigotti A, Nuñez I, Orts L, Reverter JC, Magaz M, Camprecios G, Olivas P, Betancourt-Sanchez F, Perez-Campuzano V, Blasi A, Seijo S, Reverter E, Bosch J, Borràs R, Hernandez-Gea V, Lisman T, Garcia-Pagan JC. Predicting portal thrombosis in cirrhosis: A prospective study of clinical, ultrasonographic and hemostatic factors. J Hepatol. 2021 Dec;75(6):1367-1376. doi: 10.1016/j.jhep.2021.07.020. Epub 2021 Jul 30. PMID: 34333101.
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J Hepatol. 2021 Dec;75(6):1367-1376. doi: 10.1016/j.jhep.2021.07.020. Epub 2021 Jul 30.

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

Journal of hepatology

Fanny Turon, Ellen G Driever, Anna Baiges, Eira Cerda, Ángeles García-Criado, Rosa Gilabert, Concepció Bru, Annalisa Berzigotti, Isabel Nuñez, Lara Orts, Juan Carlos Reverter, Marta Magaz, Genis Camprecios, Pol Olivas, Fabian Betancourt-Sanchez, Valeria Perez-Campuzano, Annabel Blasi, Susana Seijo, Enric Reverter, Jaume Bosch, Roger Borràs, Virginia Hernandez-Gea, Ton Lisman, Juan Carlos Garcia-Pagan

Affiliations

  1. Barcelona Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain(†); Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain.
  2. Surgical Research Laboratory, Department of Surgery, University of Groningen, University Medical Center Groningen, The Netherlands.
  3. Barcelona Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain(†).
  4. Centre de Diagnostic per l'Imatge, Hospital Clínic, Barcelona, Spain.
  5. Barcelona Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain(†); Centre de Diagnostic per l'Imatge, Hospital Clínic, Barcelona, Spain; Hepatologie, University Clinic for Visceral Surgery and Medicin, Inselspital, Bern, Switzerland.
  6. Servei d'Hemoteràpia i hemostàsia, Hospital Clínic, Barcelona, Spain.
  7. Servei d'Anestesiologia i reanimació, Hospital Clínic, Barcelona, Spain.
  8. Barcelona Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain(†); Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain; Hepatologie, University Clinic for Visceral Surgery and Medicin, Inselspital, Bern, Switzerland.
  9. Arrhythmia Section, Cardiovascular Clinic Institute, Hospital Clínic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
  10. Barcelona Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain(†); Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain. Electronic address: [email protected].

PMID: 34333101 DOI: 10.1016/j.jhep.2021.07.020

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 <15 cm/sec and history of variceal bleeding were factors independently associated with a high PVT risk. No relationship between PVT development and any other clinical biochemical, inflammatory and acquired or hereditary hemostatic parameter was found.

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.

Copyright © 2021 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Keywords: Cirrhosis; portal hypertension; portal vein thrombosis

Conflict of interest statement

Conflict of interest Prof JB is a consultant for Gilead Science, Surrozen, Actelion, BMS, Biovie and BLB. Prof JCGP is a consultant for GORE and research grants from NOVARTIS. AGC receives speaker fee

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