Predictive value of D-dimer for portal vein thrombosis after portal hypertension surgery in hepatitis B virus-related cirrhosis

Abstract

AIM:To evaluate the predictive value of D-dimer as a predictive indicator of portal vein thrombosis (PVT) after portal hypertension surgery in hepatitis B virus-related cirrhosis. METHODS:A prospective study was carried out in 52 patients who had undergone surgery for portal hypertension in hepatitis B virus-related cirrhosis. Changes in perioperative dynamic D-dimer were observed. The sensitivity, specificity, positive predictive values and negative predictive values of D-dimer were calculated, and ROC curves were analyzed. RESULTS:The D-dimer levels in the group developing postoperative PVT was significantly higher than those in the group not developing PVT (P = 0.001), and the ROC semi-quantitative and qualitative analysis of D-dimer showed a moderate predictive value in PVT (semiquantitative value Az = 0.794, P = 0.000; qualitative analysis: Az = 0.739, P = 0.001). CONCLUSION:Dynamic monitoring of D-dimer levels in patients with portal hypertension after surgery can help early diagnosis of PVT, as in cases where the D-dimer levels steadily increase and exceed 16 µg/mL, the possibility of PVT is very high.

Safety and Efficacy of Anticoagulation in Patients with Cirrhosis: A Meta-Analysis

“…Portal vein thrombosis (PVT) is a common adverse event of liver cirrhosis, and its incidence increases as liver disease progresses and is even higher in patients with various portal hypertension procedures [1][2][3]. Patients with acute and severe PVT may experience symptoms, such as fever, abdominal pain, ascites, and splenomegaly, but many patients do not exhibit symptoms in the early stage of onset [4].…”

Endothelial Dysfunction and Systemic Inflammation in the Pathogenesis and Progression of Portal Hypertension

“…Most studies that analyzed the relation and prognostic role of D-dimers in these patients confirmed significant association between the elevated D-dimers and the occurrence of PVT [153,154]. One study suggested that the risk of developing PVT in patients with liver cirrhosis was significantly higher in case of a significant postoperative rise in the D-dimers concentration that exceeded 16,000 ng/ml [153]. Zhang et al confirmed significant association between the elevated D-dimers and the occurrence of PVT independent of the CTP score [154].…”

“…On the other hand, the relation between elevated D-dimers and PVT in cirrhotic patients has also been evaluated. Most studies that analyzed the relation and prognostic role of D-dimers in these patients confirmed significant association between the elevated D-dimers and the occurrence of PVT [153,154]. One study suggested that the risk of developing PVT in patients with liver cirrhosis was significantly higher in case of a significant postoperative rise in the D-dimers concentration that exceeded 16,000 ng/ml [153].…”

Effects of modified splenocaval shunt plus devascularization on esophagogastric variceal bleeding: a comparative study of this treatment and devascularization only in cirrhotic portal hypertension

“…The portal thrombosis and obstruction decreases the amount of blood flow to the liver, increases the encephalopathy rate, and accelerates the hepatic damage [11]. Reported postoperative thrombosis rates in the portal vein were 5.8-33.6% [41][42][43] and this rate was an important prognostic factor for portal hypertension in cirrhosis [44,45]. In our experience, the longterm patency rate reached 94.9% and only 4 patients had thromboses in the modified splenocaval stoma.…”