Portal vein thrombosis in patients with cirrhosis: just a common finding or a predictor of poor outcome?

• Published in: Annals of hepatology Vol. 15; no. 6; pp. 902 - 906
• Main Authors: Borjas-Almaguer, Omar D, Cortez-Hernández, Carlos A, González-Moreno, Emmanuel I, Bosques-Padilla, Francisco J, González-González, José A, Garza, Aldo A, Martínez-Segura, Juan A, García-Compean, Diego, Alejandre-Loya, Juan V, García-García, Jesús, Delgado-García, Guillermo, Maldonado-Garza, Héctor J
• Format: Journal Article
• Language: English
• Published: Mexico Elsevier 01-11-2016
• Subjects: Adult; Aged; Aged, 80 and over; Child-Pugh Score; Cirrhosis; Computed Tomography Angiography; Disease Progression; Female; Gastroenterology and Hepatology; Humans; Kaplan-Meier Estimate; Liver Cirrhosis - diagnosis; Liver Cirrhosis - epidemiology; Liver Cirrhosis - mortality; Male; MELD Score; Mexico - epidemiology; Middle Aged; Phlebography - methods; Portal Vein - diagnostic imaging; Portal vein thrombosis; Predictive Value of Tests; Prevalence; Prognosis; Retrospective Studies; Risk Assessment; Risk Factors; Time Factors; Ultrasonography, Doppler; Venous Thrombosis - diagnostic imaging; Venous Thrombosis - epidemiology; Venous Thrombosis - mortality; Young Adult; Cirrhosis; Prognosis; Child-Pugh Score; Portal vein thrombosis; MELD Score
• ISSN: 1665-2681
• DOI: 10.5604/16652681.1222108

AbstractBackground & Aims. It is unclear whether portal vein thrombosis (PVT) unrelated to malignancy is associated with reduced survival or it is an epiphenomenon of advanced cirrhosis. The objective of this study was to assess clinical outcome in cirrhotic patients with PVT not associated with malignancy and determine its prevalence. Material and methods. Retrospective search in one center from June 2011 to December 2014. Results. 169 patients, 55 women and 114 men, median age 54 (19-90) years. Thirteen had PVT (7.6%). None of the patients received anticoagulant treatment. The PVT group was younger (49 [25-62] vs. 55 [19-90] years p = 0.025). Child A patients were more frequent in PVT and Child C in Non-PVT. Median Model for End Stage Liver Disease (MELD) score was lower in PVT (12 [8-21] vs. 19 [7-51] p ≤ 0.001) p ≤ 0.001). There was no difference between upper gastrointestinal bleeding and spontaneous bacterial peritonitis in the groups. Encephalopathy grade 3-4 (4 [30.8%] vs. 73 [46.8%] p = 0,007) and large volume ascites (5 [38.5%] vs. 89 [57.1%] p= 0,012) was more common in non-PVT. Survival was better for PVT (16.5 ± 27.9 vs. 4.13 ± 12.2 months p = 0.005). Conclusions: We found that PVT itself does not lead to a worse prognosis. The most reliable predictor for clinical outcome remains the MELD score. The presence of PVT could be just an epiphenomenon and not a marker of advanced cirrhosis.