Portal Vein Thrombosis Risk Factors in Liver Transplant Candidates

Abstract

Background: Portal vein thrombosis (PVT) is particularly detected in advanced liver cirrhosis patients. We aimed to analyze the risk factors for PVT in liver transplant candidates. Methods: Dataset for consecutive 165 cirrhotic patients who were evaluated for liver transplantation (LT) were retrospectively analyzed. We sorted patients into two groups: Patients with PVT and patients without PVT. Included variables were: age, sex, etiology of liver disease, BMI, MELD-Na Score, Child-Pugh Score, clinical variables reflecting portal hypertension and hepatocellular carcinoma. Univariate, multivariate logistic-regression analysis were used to identify risk factors of PVT. Results: Of 165 LT candidates 46 of them had PVT (27.9 %). Presence of ascites, thrombocytopenia, history of variceal bleeding and band ligation were risk factors for PVT in univariate analysis. In multivariate analysis, only history of variceal bleeding (OR 3.45, 95% CI 1.02-11.6, P = 0.046) significantly increased the risk of PVT. Conclusion: Previous history of variceal bleeding predict PVT development in cirrhosis suggesting that severity of portal hypertension is a major predictive factor for PVT in patients with cirrhosis. Future prospective studies are needed to risk stratifying cirrhosis patients prior to liver transplantation for future PVT development and to define the prophylactic role of anticoagulation in these patients.

COVID‐19 infection may present as acute abdomen

“…Portal vein thrombosis is a thromboembolic disease that mainly occurs in the setting of cirrhosis, myeloproliferative disorders, abdominal infection, inherited thrombophilia, hepatocellular or pancreatic malignancy. A previous history of variceal bleeding predicts portal vein thrombosis, suggesting that the severity of portal hypertension is a major predictive factor in patients with cirrhosis 2 . Portal vein thrombosis is a relatively rare but significant thrombotic complication in COVID‐19, with most patients presenting as a case of acute abdomen following COVID‐19 infection.…”

Risk Factors of Portal Vein Thrombosis in Patients with Different Child-Pugh Classes Liver Cirrhosis

“…Как в классах В/С, так и в классе А течение портальной гипертензии у пациентов с ТВВ чаще, чем в контроле, осложнялось кровотечением из ВРВ, рецидивами кровотечений и выполнением вмешательств, самым частым из которых было эндоскопическое лигирование. Эти переменные показаны как факторы риска ТВВ в ретроспективных исследованиях пациентов с ЦП, находящихся в листе ожидания трансплантации печени [11,12]. При проведении многофакторного анализа для класса А по Child-Pugh в одну из лучших моделей логистической регрессии вошло кровотечение из ВРВ (ОШ 29,22; 95 % ДИ 3,95-216,04), в другую -вмешательства по поводу ВРВ (ОШ 9,98; 95 % ДИ 2,57-38,76).…”

Emergencies Following Orthotopic Liver Transplant

“…Risk factors for the development of PVT are heterogeneous in the literature and most not validated, but many studies have attempted to describe various clinical parameters associated with PVT. Major risk factors for PVT are progressive liver disease severity, portal hypertension, obesity, metabolic syndrome, and NASH [146,164]. More recently, a predictive model for PVT risk (Table 4) was developed with ten recipient characteristics identifying individuals at risk of developing PVT within 12 months of liver transplantation with good predictive value.…”