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Saudi J Gastroenterol. 2014 Sep-Oct;20(5):288-92. doi: 10.4103/1319-3767.141687.

Natural course of nonmalignant partial portal vein thrombosis in cirrhotic patients.

Author information

1
Institute of Gastroenterology and Hepatology, "St Spiridon" Emergency Hospital, Iasi, Romania.

Abstract

BACKGROUND/AIM:

Portal vein thrombosis (PVT) has a high incidence in patients with liver cirrhosis and determines a poor prognosis of hepatic disease. The aim of our study was to define the natural course of partial PVT in cirrhotic patients, including survival and decompensation rates.

PATIENTS AND METHODS:

We performed a prospective, cohort study, in a tertiary referral center. There were 22 cirrhotic patients with partial nonmalignant PVT, without anticoagulant treatment, who were followed-up between January 2011 and October 2013. All patients were evaluated by Doppler abdominal ultrasound and computed tomography. Kaplan-Meier method was used to determine the difference in clinical events between the study subgroups.

RESULTS:

After a mean follow-up period of 20.22 months, partial PVT improved in 5 (22.73%), was stable in 11 (50%), and worsened in 6 (27.27%) patients. Hepatic decompensation rate at 6 and 18 months was higher in patients with worsened PVT than in those with stable/improved PVT (50% vs. 25%, P < 0.0001 and 100% vs. 56.25%, P < 0.0001, respectively). The survival rate at 6 months was 66.66% in worsened PVT group vs. 81.25% (P = 0.005) in stable/improved group, and 16.66% vs. 81.25% (P < 0.0001) at 18 months, respectively. Multivariate analysis showed that Model of End-Life Disease was the independent predictor of hepatic decompensation [hazard ratio (HR) 1.42; 95% confidence interval (CI): 1.08-1.87, P = 0.012] and survival (HR 1.76; 95% CI: 1.06-2.92, P = 0.028).

CONCLUSIONS:

Nonmalignant partial PVT remained stable/improved in over half of cirrhotic patients and aggravated in more than one fourth in whom it negatively influenced the survival and decompensation rates.

PMID:
25253363
PMCID:
PMC4196343
DOI:
10.4103/1319-3767.141687
[Indexed for MEDLINE]
Free PMC Article

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