The impact of portal vein thrombosis on the prognosis and liver function of nonmalignant cirrhotic patients

Scand J Gastroenterol. 2018 Oct-Nov;53(10-11):1340-1346. doi: 10.1080/00365521.2018.1503327. Epub 2018 Sep 26.

Abstract

Objectives: The clinical impact of portal vein thrombosis (PVT) in cirrhotic patients remains unclear. The aim of the study is whether recanalization of acute PVT in nonmalignant cirrhotic patients is associated with their prognosis.

Materials and methods: We identified subject with PVT in cirrhotic patients from institutional database. Patients with ≥50% reduction in thrombus size were classified into the improved group and those with ≤49% reduction in thrombus size, or thrombus development in other branches were classified into the deteriorated group. We compared the cumulative survival rate, event-free survival rate (EFS), and liver function (albumin-to-bilirubin (ALBI) and model for end-stage liver disease XI (MELD-XI) between the two groups.

Results: Twenty-seven patients were enrolled in this retrospective study. Sixteen patients were classified into the improved group, and 11 were classified into the deteriorated group. In the improved group, the ALBI grade and MELD-XI measured before the onset of PVT and at one year after the onset of PVT were not significantly different. In contrast, MELD-XI was significantly aggravated in deteriorated group (MELD-XI [p = .02]). The cumulative survival of the two groups did not differ significantly; however, the EFS of the deteriorated group was significantly lower (p = .049).

Conclusions: Residual thrombosis of PVT in cirrhotic patients increased the incidence of liver-related events and was associated with the deterioration of the liver function.

Keywords: MELD-XI; Portal vein thrombosis; albumin-to-bilirubin (ALBI); cirrhotic patients; liver-related events.

MeSH terms

  • Aged
  • Aged, 80 and over
  • End Stage Liver Disease / mortality
  • End Stage Liver Disease / physiopathology*
  • Female
  • Humans
  • Incidence
  • Japan / epidemiology
  • Liver / physiopathology*
  • Liver Cirrhosis / complications*
  • Liver Cirrhosis / diagnosis
  • Liver Function Tests
  • Male
  • Middle Aged
  • Multidetector Computed Tomography
  • Portal Vein / physiopathology*
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Survival Rate
  • Venous Thrombosis / complications
  • Venous Thrombosis / diagnostic imaging
  • Venous Thrombosis / epidemiology*